Are Women (And Doctors) Missing Warning Signs of Heart Problems? Here’s What To Look For

Women suffer from heart disease just as much as men, but a lack of awareness about that fact means too many women fail to recognize the symptoms until it’s too late.

And it doesn’t help that the warning signs can be subtle, says Dr. Jennifer Mieres, co-author with Dr. Stacey E. Rosen of Heart Smarter for Women: Six Weeks to a Healthier Heart (www.heartsmarterbook.com).

“Women often ignore what they think are minor aches and pains, but you need to know that if something doesn’t feel quite right, it probably isn’t,” says Mieres, who is professor of cardiology at the Zucker School of Medicine and SVP Center for Equity of Care, Northwell Health.

“Trust your intuition. Make a doctor’s appointment and get yourself checked out.”

Making things even more problematic is that heart disease symptoms sometimes mimic less serious conditions.

“Heart disease can masquerade as indigestion, breathlessness, or general fatigue, thereby delaying early diagnosis,” says Rosen, a practicing cardiologist and senior vice president for Northwell Health’s Katz Institute for Women’s Health.

“For women, a heart attack or heart disease can present with symptoms other than chest pain or chest pressure.”

Some symptoms more common in women than men include:

• Uncomfortable pressure, fullness, squeezing sensation or pain anywhere in the chest or back. These symptoms may last only a few minutes or longer; they may persist or occur sporadically. “None of these symptoms is normal in a healthy woman,” Mieres says.
• Mild or intense pain that begins in the chest and spreads to the shoulders, neck, jaw, or arms. This can happen on the left or right side. “This type of pain can come on suddenly and can even wake you up, or it can come and go before getting more intense,” Rosen says.
• Unexplained dizziness, lightheadedness, or fainting. These symptoms may or may not be accompanied by palpitations.
• Shortness of breath or difficulty breathing with or without discomfort in the chest. This feeling can be experienced by itself or may be combined with nausea or lightheadedness, Mieres says.
• Clammy sweating. This is the type of sweating that usually comes with feeling anxious or stressed out; it feels different from sweating when you are experiencing a hot flash, are in a warm place, or are exercising, Rosen says. “Breaking out in a nervous or cold sweat is a symptom very common in women who are having a heart attack,” she says.
• Stomach pain, abdominal pressure, or nausea that may feel like common indigestion, the flu, or a stomach ulcer but can also feel like a weight sitting on your stomach.
• Back pain that may mimic muscle pain related to overexertion.
• A feeling of weakness or fatigue, or being unable to perform even simple tasks or activities. “The onset of any of these symptoms may or may not be sudden and without any obvious cause,” Mieres says. She adds that they are sometimes combined with vague feelings of a lack of mental sharpness and that something is “just not right.”

Unfortunately, Mieres and Rosen say, many doctors still focus on the most common symptoms of chest pain or discomfort.

“Of course, that’s problematic for women, since many of them do not exhibit this symptom alone, leading to a heart attack going undiagnosed,” Rosen says. “That is why you need to advocate for yourself and help your doctor diagnose your heart attack. It could save your life.”

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