There’s no mistaking a heart attack, right?
Wrong. Some people do misread the important signs that something’s amiss.
Chances are, you’ve heard the “elephant on my chest” analogy—sudden, extreme chest pain and pressure. Those are common indicators of a serious problem.
Women, however, often display more subtle signs of heart trouble, making it easier to miss the clues.
“Women can often experience significant shortness of breath, extreme fatigue, or they just don’t feel well,” Corewell Health cardiologist Thomas Boyden, MD, said.
Other signs include neck, jaw or shoulder pain, or nausea or sweating.
“These symptoms are much harder for people to pick up on,” Dr. Boyden said.
Missing or ignoring the signs can have deadly consequences.
“Even though (heart disease) is the No. 1 cause of death for men and women, women are more likely to die of heart attacks than men,” Dr. Boyden said.
Both women and men should not put off seeing their doctor, whether they experience chest pain or more subtle signs, he said.
“We see that all too often,” Dr. Boyden said. “They didn’t come in because they felt something else was going on. Eventually they felt worse and now they have heart failure.”
It’s important to seek prompt medical attention.
“The quicker you are able to restore blood flow to the heart, the less likely you are to have damage to the muscle,” Dr. Boyden said.
Follow your heart
Heart disease kills roughly 700,000 people a year. Men and women who experience severe symptoms such as chest pain tend to seek attention right away.
But many women—and men, for that matter—dismiss more subtle symptoms, or they delay seeking care.
“I think a lot of people miss cues for heart attacks,” Dr. Boyden said. “Part of it is they don’t want to believe they are having (a heart attack). If it’s not classic or severe, they hope it’s something that will go away.”
When subtle symptoms come on suddenly—during physical activity or times of emotional stress, for example—that’s a red flag.
“The heart is under stress when you’re under stress,” Dr. Boyden said. “If you’re feeling symptoms that could be related, those things should be taken seriously.”
Those at higher risk for heart disease should practice special vigilance. Conditions that can elevate risk include diabetes, high blood pressure, high cholesterol, smoking or inflammatory diseases such as lupus and rheumatoid arthritis.
“If you have some of these conditions and you develop these symptoms, you have to take it real seriously,” Dr. Boyden said.
It can sometimes be challenging to recognize subtle signs of heart disease in women, studies have shown.
“If you’re having a heart attack and go to the ER, that’s easy to find for all of us,” Dr. Boyden said. “There’s actual tissue damage to the heart.”
However, “if your labs look OK and your EKG looks OK and your symptoms aren’t classic, it might be missed,” Dr. Boyden said.
Recognizing these subtle signs can help identify problems such as angina—a lack of oxygen to the heart—before a heart attack occurs.
Women are also more likely to have microvascular disease, a thickening of the inner walls of the tiny blood vessels that can lead to the coronary artery disease.
Both women and men, young and old, can benefit from talking to their doctor about preventing heart disease before symptoms arise.
“There’s a lot of things we can teach patients about lifestyle, nutrition, stress management,” Dr. Boyden said.
Medications such as statins can help stabilize plaques. And if you’re a smoker, quitting the habit is one of the most important things you can do to improve heart health.
The good news? At least 80% of heart disease is preventable, he said.
“For the most part, it really comes down to individuals’ behaviors, habits, how they are taking care of themselves and staying on top of chronic diseases,” Dr. Boyden said.
“Unfortunately, it’s the No. 1 killer. And most of that is self-inflicted.”