Health Team

Women's Symptoms for Heart Attacks Can Differ Markedly

Women and their doctors need to understand that their symptoms for heart attacks may differ markedly from the widely known ones expected for men.

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When it comes to heart attacks, men and women are not created equal. Each gender is just as much at risk, but their symptoms are often different.

Classic chest pain is the symptom most people associate with a heart attack, but it’s not the only symptom. That’s especially true for many women. Their symptoms can start slowly and can be hard to recognize, even for some doctors.

Heart disease runs in Julie Mayhue’s family. “My father was 48 when he dropped dead of a heart attack, and my mother had two heart attacks when she was 44,” said Mayhue. Now she is in a WakeMed heart-rehabilitation class because she had symptoms of a heart attack at just 36 years of age.

She wasn’t sure it was a heart attack at first, and neither were some of her doctors. “I had two general doctors and one cardiologist misdiagnose me,” said Mayhue. One doctor thought her problem was just acid reflux and prescribed a medication for that.

Mayhue had some shoulder pain, a little discomfort in her left arm, shortness of breath and indigestion. Given her risk factors, cardiologist Dr. Rama Garimela saw red flags.

“She has very bad family history. She’s a diabetic. She has high blood pressure,” said Garimela. Mayhue was also a smoker, had sleep apnea, and she was overweight, sedentary and—by her own admission—ate the wrong kinds of food.

Diabetes was Garimela’s biggest concern for Mayhue. “Her symptoms were not really typical, but she’s a diabetic, so she won’t have—especially diabetics—won’t have typical symptoms,” said Garimela.

A heart catheterization showed 100 percent blockage of one coronary artery and 80 percent in another. Mayhue had a stent procedure to restore normal blood flow to her heart. She’s on heart medications and is living a healthier lifestyle. “I’m exercising. I’ve stopped smoking. I’m eating right,” said Mayhue. She says she feels like a new woman.

Other possible symptoms of a heart attack in women could include chest discomfort that lasts for more than a few minutes or goes away and comes back. You might feel pain in the upper body, the neck, jaw or back. Look for shortness of breath with or without chest pain. Some women just break out in a cold sweat.

Mayhue says she’s learned to be her own advocate. Garimela says patients who suspect they might be experiencing symptoms of a heart attack should insist on tests to confirm it. If you’re not satisfied with one doctor’s diagnosis, get a second opinion.

For more information on heart health, visit the American Heart Association’s Web site.