There’s a reason why stereotypes are formed. Picture this: you’re watching a commercial that’s either supposed to raise awareness about heart disease or is made to promote a medication to remedy the same. When they show you a heart attack, it’s often the crushing chest pain that’s in focus.Similarly, when we think of a heart attack, we picture sudden and acute chest pain.However, for many women out there, the signs of a heart attack are far more subtle and hence, easy to miss. Instead of dramatic symptoms, they may experience fatigue, nausea, shortness of breath, or even a sense of unease. Because these signs are often mild or vague, they can be easily dismissed as everyday discomforts. And ignoring these hidden warning signals can be dangerous. Dmitry Yaranov, MD (cardiologist), who goes by the username of “heart_transplant_doc” on Instagram, urges the same, saying, “Heart attacks in women often don’t look like heart attacks at all. In my practice, I’ve seen so many women with symptoms they never expected would be related to their hearts—nausea, back or jaw pain, sudden fatigue, shortness of breath.” As per him, “These symptoms can be subtle, making it easy to think it’s ‘just stress’ or something minor.” He also adds, “We need to recognize that women’s heart symptoms are often different than men’s. If something feels off, listen to your body. Don’t wait until it’s an emergency—trust your instincts and take action. Early recognition is key, and advocating for better heart health awareness for women can save lives.”So, what are these subtle symptoms that might be sending SOS signals before the attack actually happens? Understanding these lesser-known signs is vital because early help can make all the difference.
Unusual fatigue and weakness
Do you feel exhausted lately, more than usual? Do you feel like you’ve drained all your energy just after doing simple daily chores? One of the most common subtle signs among women is extreme tiredness, even after rest. This fatigue often builds up gradually and may persist for days or weeks before other symptoms appear. Simple tasks can feel unusually exhausting, hinting that something more serious might be underway.
Shortness of breath, lightheadedness, or dizziness
Women may feel breathless even when not active, or lightheaded and dizzy without warning. No, it’s not always the exhaustion from physical labor, or even a mere fluctuation in the blood pressure level. These symptoms can mislead one to think of stress, low blood pressure, or respiratory issues. Yet they can be a sign of insufficient oxygen getting to the heart or brain.
Jaw, neck, back, shoulder, or arm discomfort
Pain may radiate to areas far from the chest, such as the jaw, neck, upper back, shoulders, or arms. Ana again, they might not be the consequence of just spending yourself too much, and dealing with a lot of stress, despite often being perceived that way. These sensations may feel like muscle strain, tightness, or pressure, rather than sharp pain, making it easy to ignore.
Digestive symptoms: Nausea, indigestion, or stomach pain
Do you feel a strange, unexplained discomfort inside your stomach? It might not be the food or any regular bowel movement issues. Symptoms like nausea, vomiting, indigestion, or upper abdominal pain are common in women experiencing heart attacks. These can be misread as heartburn, flu, or food poisoning, causing delays in seeking help.
Cold sweats, clammy skin, or anxiety
Although most of us brush them away thinking that symptoms like anxiety and cold sweats are issues related to stress and mental health, in reality, they can be as much as subtle signs of an onset of a heart attack. Apart from being the obvious symptoms, these are quiet but common signs that often come along with, or instead of, other more prominent and recognizable symptoms of a heart attack.
Sleep disturbances
Disturbed sleep, trouble falling asleep, waking frequently, or still feeling exhausted after a full night’s rest aren’t always screaming insomnia, a sleep disorder, or simply a consequence of stress; they can signal something deeper at play. Research reveals that many women notice these changes days or weeks before a heart event.
Silent or ‘invisible’ heart attacks
As the name suggests, some heart attacks show up with almost no symptoms. Known as ‘silent’ heart attacks, these events can go undetected, even by the person experiencing them. Women may attribute mild discomfort or indigestive feelings to stress or fatigue, only to later discover heart damage via medical tests like ECG or MRI.
Why women’s symptoms are often misunderstood
Heart disease is the leading cause of death for women, yet awareness of warning signs is significantly lower. Conforming to the stereotypes, severe chest pain is still viewed as the only signal of a heart attack.Furthermore, biological and hormonal differences in women also shape how symptoms appear. Conditions like coronary microvascular dysfunction (CMD) or artery spasms can cause unusual chest discomfort but go undetected in standard tests. Women may experience heart attacks without large arterial blockages due to microvascular dysfunction or artery spasms (MINOCA). Another example: spontaneous coronary artery dissection (SCAD) is a rare but serious cause, particularly in younger women, postpartum, or those healthy otherwise.There’s also a well-documented gender bias in heart disease care, sometimes called the ‘Yentl syndrome’, where women’s symptoms are under-recognized or misclassified, delaying diagnosis and treatment.
What you can do: Prevention, awareness, and action
Learn and share the subtle signsKnow that symptoms in women often go beyond chest pain, such as fatigue, breathlessness, discomfort in odd places, stomach issues, sweating, dizziness, or sleep problems, which can all be warning signs.Early action mattersQuick response saves lives. Delays can lead to serious heart damage or fatal outcomes. Call emergency services immediately if you suspect a heart attack, even without chest pain.Know your risk factorsConditions such as high blood pressure, diabetes, high cholesterol, obesity, smoking, family history, and hormonal factors (like menopause or pregnancy-related conditions) elevate heart attack risk in women.Advocate for yourselfIf symptoms come on suddenly or feel wrong, insist on a timely medical evaluation. Be clear with healthcare staff, it might not be anxiety or indigestion, but a heart issue.Maintain good heart healthStay active, eat a heart-healthy diet, manage stress, avoid smoking, and schedule regular check-ups for blood pressure, cholesterol, and diabetes, especially important for post-menopausal women.