Early Signs Of Heart Attack In A Woman

The human body is designed to monitor and provide signals when it senses danger. For example, any heart problem felt during an extensive workout or after a long drive might have an aggressive throbbing impact. This is because a heart problem is not only triggered in the particular area but also radiates discomfort elsewhere, generating an alert response. 

Unlike movie scenes where people clutch their chest before losing consciousness, in real life, a heart attack victim, particularly a woman, may experience several complications. Although both men and women display similar typical symptoms, identifying the risk factors and unique symptoms in women can help to avoid serious consequences.

About Heart Attacks

Cardiovascular diseases (CVDs) are a major global threat due to their detrimental effects over decades. Generally, CVDs occur due to the involvement of various risk factors that are associated with an individual’s poor lifestyle and other health conditions. Coronary heart disease (CHD), which is the most common type of cardiovascular disease, develops when plaque starts to deposit in one or more of the coronary arteries. Eventually, this leads to a heart attack caused by a lack of blood flow to the heart muscle. Without proper blood flow, the affected heart muscle will begin to deteriorate. If the blockage is left untreated, a heart attack can cause a life-threatening emergency.

According to the World Health Organization, 17.9 million people lost their lives due to cardiovascular diseases in 2019, representing 32% of the global death toll. And 85% of those were because of heart attack and stroke.

The British Heart Foundation mentioned that coronary heart disease (CHD) caused more than twice the number of deaths among women as compared to breast cancer in the UK per year, and it was considered the number one worldwide killer among females in 2019. Also, more than 800,000 women in the UK are affected by coronary heart disease.

Causes of heart attack 

Like all muscles in the body, the heart also needs oxygen to pump blood. During a heart attack, there’s an obstruction in one or more of the tiny tubes of the heart called coronary arteries, which are responsible for supplying oxygen to every nook of the heart muscles. 

This blockage causes cardiac muscles to suffocate due to the accumulation of a sticky substance called plaque, which narrows the blood vessels. These plagues can develop when some irritants such as smoking, high blood pressure, stress, or obesity can cause stretching and tearing of the coronary arteries, severely damaging them. A poor diet (high cholesterol) promotes a fatty build-up in the cracks of the arterial wall, increasing stiffness and restricting blood flow, a condition known medically as arteriosclerosis. 

If the deposited plaque ruptures inside the vessel, it can come into direct contact with the blood flow. This can cause platelet adherence followed by blood cell entrapment to form a blood clot (thrombus) in the ruptured area, occluding the vessel. The affected muscle area cannot sustain its cardiac function due to a lack of blood flow which is known as an infarct. This overall process is medically referred to as myocardial infarction (heart attack).

Early signs of heart attack

The vast majority of patients have somewhat typical early signs. Whereas, women generally experience some atypical symptoms which are often misunderstood as a minor cause of heart attack. This may include fatigue, a sense of unease, cold sweat, acid reflux, and decreased stamina.

A study finding stated that the cardiovascular signs among the female population are challenging to evaluate because of the atypical nature of their presentation.1 Because women may experience slightly different symptoms than men, it is critical to monitor for atypical symptoms to reduce the risk of heart disease.

Symptoms of heart attack 

There are several different heart attack symptoms, some of which are more prevalent than others. Sometimes symptoms, especially in women, are less obvious and more subtle. For this very reason, many women might not be aware of what to look for.

Chest pain

Chest pain, often known as angina, occurs when the heart does not receive oxygen-rich blood. This is the most common sign of a heart attack, which involves discomfort or a squeezing pain in the middle or left side of the chest. At times, the pain may also feel like heartburn (indigestion). The chest pain may be vague because women might have obstructions not only in their main arteries but also in the tiny vessels that supply blood to the heart, a condition called coronary microvascular disease.

Extreme fatigue

Patients assume the extreme fatigue they are experiencing is due to ageing or other factors. In fact, the blockages in blood vessels could be the real culprit. This is because when blood flow declines, it puts extra strain on the heart muscles to pump blood, leading to more exhaustion.

Shortness of breath

People may notice breathing problems while performing small activities, which may get worse after lying down. Shortness of breath often comes along with chest pain due to cardiac muscle exertion.

Stomach pain

Sometimes, chest pain or heaviness may extend down to the abdominal area, causing stomach aches. This is often mistakenly taken as heartburn or indigestion.

Pain in arm(s), back, neck or jaw

Individuals with a heart condition experience pain radiating to the jaw (like a stabbing toothache), back, neck, or arms, which is difficult to pinpoint its origin.


When cardiac output does not meet the demand of the body, it puts extra pressure on the heart muscles. This causes hyperactivation of sweat glands to profuse more sweat to sustain body temperature. 2

Differences between symptoms of heart attack in women and in men 

The difference in symptoms in both men and women is wide-ranging. One of the reasons is that a female’s coronary arteries are smaller in comparison to a male's, which makes it difficult to observe through a typical angiogram to test for fatty build-up.

The symptoms of a heart attack itself also vary. Chest pain and discomfort crop up in both genders, but women mostly experience anomalous signs, such as nausea or light-headedness.3 Doctors find it difficult to recognise signs of heart attacks in women due to atypical symptoms.

Risk factors for women

Several key factors affect the risk of having a heart attack, such as advanced age and high blood pressure. Some of the risks have more prevalence in women.


Women with diabetes are more prone to experience heart issues. Certain factors linked with diabetes, such as high blood pressure or cholesterol, can increase the possibility of a heart attack. Diabetic changes can affect nerves in the body, which increases the risk of a silent heart attack.


Oestrogen decline in older women generates a potent risk for heart disease. Menopause significantly impacts female fat alteration profile with other factors that worsen cardiovascular problems.

Pregnancy complications

The combination of physiological and hormonal changes might be related to cardiovascular complications during pregnancy. Specific changes in the maternal heart can cause thickening of the heart wall, which may obstruct blood flow. Moreover, a history of preeclampsia can increase the 2-fold risk of a heart attack after pregnancy. Other complications, such as excessive weight gain, can harm foetal development. 4


Chemicals in cigarettes cause a blood clot to form in the arteries which increase the risk of a heart attack.

Stress and depression

Emotional stress and depression can elevate levels of stress hormone (cortisol) and chances of hypertension which may lead to plaque formation causing heart diseases.

Lack of physical activity

Being inactive is a major cause of fat build-up in coronary arteries. If arteries get clogged, it can lead to a heart attack or even a stroke.

Family history

Many cardiac disorders, such as coronary artery disease (CAD) can be inherited. A family history of cardiac problems is a risk factor for developing a heart condition.

Living a healthy lifestyle

There are several healthy lifestyle choices you make to reduce your risk of a heart attack, including

  • Having a healthy diet.
  • Regular physical activity for at least 20-30 minutes.
  • Quitting all smoking products.
  • Reducing stress with effective techniques such as yoga.
  • Managing existing health problems can significantly help to improve heart health and overall quality of life.

When to see a doctor

It is recommended not to delay and consult a doctor immediately if you have the following symptoms:

  • Unusual chest pain or discomfort.
  • Extreme fatigue.
  • Rapid/ irregular heart rate.
  • Disturbances in sleeping patterns.
  • Trouble breathing
  • Continuous lightheadedness
  • Nausea/loss of appetite
  • Abnormal or excessive sweating.
  • Severe headaches.


A heart attack, or myocardial infarction, is a deadly medical emergency that affects both men and women. Identifying risk factors, and early atypical complications in women and implementing appropriate lifestyle changes may help to reduce cardiovascular problems, including the risk of a heart attack.


  1. Keteepe-Arachi T, Sharma S. Cardiovascular Disease in Women: Understanding Symptoms and Risk Factors. European Cardiology Review. 2017;12(1):10.
  2. Hyperhidrosis: the neglected sign in heart failure patients. American Journal of Cardiovascular Disease [Internet]. 2021 Oct 25;11(5):635–41. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8611272/
  3. Ramamoorthy L, Joseph N, Satheesh S. Atypical manifestations of women presenting with myocardial infarction at Tertiary Health Care Center: An analytical study. Journal of Mid-life Health. 2021;12(3):219.
  4. Iftikhar SF, Biswas M. Cardiac Disease In Pregnancy [Internet]. PubMed. Treasure Island (FL): StatPearls Publishing; 2020. Available from: https://www.ncbi.nlm.nih.gov/books/NBK537261/

Get our health newsletter

Get daily health and wellness advice from our medical team.
Your privacy is important to us. Any information you provide to this website may be placed by us on our servers. If you do not agree do not provide the information.

Sadaf Ahmed

Master of Science - MSc, Physiology, Clinical & Molecular Hematology, Karachi University, Pakistan

Sadaf is an experienced writer who creates a quality and well-researched scripts particularly related to Health Sciences.

Leave a Reply

Your email address will not be published. Required fields are marked *

Klarity is a citizen-centric health data management platform that enables citizens to securely access, control and share their own health data. Klarity Health Library aims to provide clear and evidence-based health and wellness related informative articles.