Recognizing Heart Attacks in Women & Females: Understanding Symptoms and Advocating for Yourself

Heart disease remains the leading cause of death for both men and women worldwide. However, recent research has shed light on an alarming disparity: women are more likely to die from heart attacks than men. One of the reasons behind this discrepancy is the failure to recognize heart attack symptoms in women, which can differ significantly from those typically seen in men. Understanding these differences and knowing how to advocate for yourself can be lifesaving.


Traditionally, heart attack symptoms have been based on male presentations, often characterized by chest pain or pressure. However, studies have shown that women may experience a wider range of symptoms, some of which may not even involve chest discomfort. Instead, women are more likely to report symptoms such as shortness of breath, nausea, vomiting, back or jaw pain, and extreme fatigue. These atypical symptoms can lead to delayed diagnosis and treatment, increasing the risk of complications and death.

Recent scientific research has highlighted the importance of recognizing these gender-specific differences in heart attack symptoms. For example, a study published in the Journal of the American Medical Association found that women were more likely to experience non-chest pain symptoms leading up to a heart attack. Other studies have revealed that women may experience gastrointestinal symptoms during a heart attack, such as indigestion or abdominal discomfort. Turns out, there’s a BIG difference.


Most of us have an idea in our heads about heart attacks, in large part due to what we see on television or in the media. If the image in your head is of an unhealthy older male clutching his chest and falling suddenly to the ground, you’re not alone. We’re all conditioned with that image, which can leave us feeling safe and less likely to properly recognize a heart attack coming on. So let’s break this scenario down, and ladies especially, listen up!

Men are more at risk for heart attack than women.

Men and women are each just as likely to have a heart attack. As mentioned above, women are more likely to die from one. In fact, women have a 20% higher risk of developing heart failure or dying in the 5 years following their first severe heart attack.

I don’t need to worry about heart attacks until I’m older.

Risks increase with age, but heart attack frequency in older populations is decreasing while frequency in women 35-54 is increasing. Yikes! Did you know that combining birth control pills and smoking can increase your risk by 20% alone?

Being fit means I’m not at risk.

You’ll still need to get blood pressure and cholesterol checked regularly. Healthy habits go a long way toward keeping these in check, but genetics play a big role, too. Some women may find that they’ve had great cholesterol their whole life, and be surprised to see it suddenly increase in their 50s or 60s without any dietary changes. Best practice is to check early and check often. The American Heart Association recommends starting to get cholesterol checked at age 20 (tell your kids!).

Heart attacks come on with severe chest pain.

As we mentioned above, this is not necessarily true. Especially in women, heart attacks can present with no chest pain at all.

Heart attacks come on suddenly.

The US Army reports that “research suggests that women experience symptoms for several weeks before a heart attack.” Read that again- WEEKS! As women, we tend to downplay our symptoms, but if they’re persisting without getting better, get checked! Outcomes vary greatly depending on how far the myocardial infarction (MI) progresses. 


Given these realities, it’s crucial for women to be aware of the varied symptoms of a heart attack and to advocate for themselves if they suspect they may be experiencing one. Here are some steps women can take to protect their heart health and ensure they receive timely medical attention:

  • Know Your Numbers: Prioritize getting your blood pressure and cholesterol checked regularly. 
  • Know the Symptoms: Familiarize yourself with the diverse symptoms of a heart attack in women, including chest pain or pressure, shortness of breath, nausea, vomiting, back or jaw pain, and extreme fatigue. Don’t ignore any unusual symptoms, especially if they persist or worsen over time.
  • Trust Your Instincts: If you feel that something isn’t right, don’t hesitate to seek medical help. Trust your intuition and advocate for yourself, even if your symptoms don’t fit the traditional “heart attack” mold.
  • Be Prepared to Advocate: When seeking medical care, be prepared to communicate your symptoms clearly and assertively. Don’t downplay or dismiss your concerns. It’s important to be your own advocate and insist on further evaluation if necessary.
  • Request Appropriate Tests: If you suspect you may be having a heart attack, ask your healthcare provider for specific tests that can help diagnose the condition. These may include an electrocardiogram (ECG or EKG), blood tests to check for cardiac enzymes, and imaging tests such as an echocardiogram, a coronary catheterization (angiogram) a chest X-ray, or a cardiac CT or MRI.
  • Seek Treatment Promptly: Time is of the essence when it comes to treating a heart attack. If you or someone you know is experiencing symptoms suggestive of a heart attack, call emergency services immediately. Don’t wait to see if the symptoms improve on their own.

By understanding the unique symptoms of heart attacks in women and advocating for themselves, we can play a proactive role in protecting heart health. Talk with others around you to help raise awareness about these gender-specific differences and ensure that women and females receive the appropriate medical attention they need in the event of a heart attack. Remember, your health is worth prioritizing, and early detection and treatment can save lives.


While we used the gendered language consistent with that used in studies throughout this article, it is important to note the problematic language usage that exists throughout research studies which freely substitutes gender for sex. We strongly encourage everyone to discuss the disparities that can exist which we assume extends to biologically female individuals who identify as non-binary, men, or any gender other than women. 

Additionally, at the time of writing this article, there are insufficient studies on heart disease risk for transgender individuals using gender-affirming hormone treatments (GAHT). What is out there thus far suggests that transgender men (those assigned female at birth) may have twice the risk of heart disease as cisgender men, and that the estrogen taken by transgender women may increase their heart disease risk as well. We hope future quality studies will shed light and understanding on the role of GAHT versus psychosocial, emotional, and other potential factors on cardiovascular health in our transgender community.