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Heart Attack in Women

Most people have heard that cardiovascular disease is the leading cause of death in the US. Cardiovascular disease comes in many forms, any of which may lead to a heart attack or stroke. What you may not know is that men and women may have different heart attack risk factors and warning signs.

If you're a woman, heeding the subtle warnings can make a significant difference.

What Can Cause a Heart Attack

Your heart is a constantly running pump and needs a constant source of oxygen and fuel. The oxygen is picked up in the blood and delivered to the heart muscle through blood vessels called arteries. Blockages or damages to these coronary arteries slow or block the flow of blood to the hard working heart muscle. In a short period of time, the lack of blood flow causes leads to heart muscle damage. If the oxygen is restored quickly, long-term damage may be prevented. Continued lack of oxygen can cause significant damage to the heart, which can lead to disability or even death.

The most common cause of a heart attack is atherosclerosis or coronary artery disease (CAD). These conditions are caused when fatty deposits, called plaque, build up on the walls of the arteries. This build-up causes a narrowing of the arteries that restricts the blood flow. This plaque can also cause a tear or rupture in the artery, which leads to the formation of a blood clot. The blood clot can cause a sudden blockage in the blood flow in the artery.

Other times, a spasm of the artery can contribute to a heart attack.

How Men and Women Differ

Heart Attack Symptoms

When it comes to heart attack symptoms, men and women share several similarities.

Similarities in symptoms include:

  • Discomfort or pain in the center of the chest—many times, it feels like pressure or squeezing that may last a long time, or go away and come back
  • Discomfort or pain in the jaw, arms, back, neck, or stomach
  • Shortness of breath with or without chest pain
  • Cold sweat
  • Nausea or vomiting
  • Lightheadedness

Women often have other, more subtle symptoms that may seem confusing, and not so obvious.

Other common symptoms in women may include:

  • Extreme fatigue, which may occur days or weeks in advance
  • Pressure or pain in the lower chest, upper abdomen, or upper back
  • Lightheadedness, which may lead to fainting

Remember that some of these symptoms can occur over hours, days, or weeks. If you feel these symptoms, don't wait more than 5 minutes to call for emergency medical services. Even if you have a friend or relative with you, call for medical help rather than drive. If necessary, paramedics can start life-saving treatment on the way to the emergency room. This early care can determine how well you recover.

Know Your Risks

Most women believe that breast cancer is the biggest threat to good health. The fact is, heart disease causes 6 times as many deaths in women as breast cancer. This makes heart disease the leading cause of death among women as well as men.

There are several factors that increase your chance of having a heart attack. The more factors you have, the higher the risk of a heart attack. In men and women, many risk factors are the same.

Uncontrollable risk factors are those you can't change. These factors include:

  • Increasing age
  • Race or ethnicity
  • Family history of cardiovascular disease
  • Previous heart attack

Controllable risk factors include those that can be modified by lifestyle changes and medications. These include:

Other factors that are specific to women include:

  • Younger age at menopause
  • Hormonal replacement therapy (HRT)
  • Use of birth control pills, especially in heavy smokers

Before menopause, women have a slightly lower risk of heart attack than men. However, postmenopausal women have a similar risk for heart attack as men.

Changes You Can Make to Prevent a Heart Attack

To help reduce your chances of a heart attack, take these steps to modify your lifestyle:

In addition to lifestyle changes, you need to monitor and take care of other health conditions:

Change is not always easy, so start slowly. The more risk factors you control, the better chance you have to ward off a heart attack. Talk with your doctor about the best course of action for you.

Take the time to learn the signs of a heart attack, and don't be afraid to call for emergency medical services.


American Heart Association

National Coalition for Women with Heart Disease


Heart & Stroke Foundation of Canada

Public Health Agency of Canada


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Last reviewed April 2017 by Michael Woods, MD, FAAP  Last Updated: 4/3/2017