How Heart Attacks Affect Men And Women Differently

Everyone’s seen a heart attack as portrayed on TV or in a movie. It’s often a male victim, who clutches their chest in pain and falls to the ground. It takes no more than five seconds for someone to insist an ambulance be called. 

In real life, heart attacks usually play out more subtly. Estelle Darlyse Jean, MD, a board-certified cardiologist at MedStar Montgomery Medical Center, says “the symptoms often feel less dramatic than the typical images you may have” of the obvious, dramatic heart attack victim. It’s important to know this because heart attacks are ultra common—in the United States, and across the world.

What a Heart Attack Looks Like

Heart disease is one of the leading causes of death in men and women globally and refers to “any condition that affects the heart or its blood vessels,” according to Laxmi Mehta, MD, a cardiologist and section director of Preventative Cardiology & Women’s Cardiovascular Health at The Ohio State University Wexner Medical Center. “It can include heart attacks, heart failure, cardiomyopathies, arrhythmias, heart valve problems, and congenital heart disease,” she says. 

More specifically, a heart attack occurs when there is “inadequate blood flow” in any artery that supplies blood to the heart; according to the CDC, there are 805,000 heart attacks every year in the United States. “This can occur when a plaque—which are fatty and calcified deposits on the arterial wall—ruptures, and then results in a blood-clot formation that obstructs blood flow in the artery,” says Mehta. “Heart attacks can also occur when there is intense prolonged spasm of the artery, or when there is a dissection, or tear, in the arterial wall.”

It’s critical for women to note, especially, that the chest-clutching heart attacks they’ve seen on screen may be far different from their personal set of symptoms. “The most common symptom is chest discomfort or pain in both men and women, but women are more likely to have atypical symptoms, such as shortness of breath, dizziness, indigestion, nausea, vomiting, upper body discomfort in the neck or jaw, and back pain without any chest discomfort,” says Jean.

Other symptoms more frequently noted among women are palpitations, extreme tiredness, cold sweats, trouble sleeping, and sudden anxiety or confusion, Jean explains. “Thankfully, more people are becoming aware that heart attack symptoms are different for men and women, but we still have more work to do in increasing awareness.”

When to Call a Doctor

First, if you have any symptoms you think might be cardiovascular in nature, then you need to get evaluated by a healthcare professional promptly. “Too often, women minimize their symptoms for fear of being wrong or ‘bothering’ their healthcare provider,” Jean says. “Many of my patients also are juggling being a caregiver, and frequently put themselves last on the neverending to-do list. Unfortunately, an important reason why women have worse outcomes than men [after heart attacks] is because of delayed presentation, which can result in greater heart muscle damage from their heart attack.” 

Of course, you or someone you love may have symptoms that are imminently disconcerting, indicates Mehta. “If someone is having symptoms that occur with activity and resolve with resting a couple of minutes, call your doctor for urgent evaluation,” she says. “If someone is experiencing the heart-attack symptoms listed above, or symptoms at rest, or severely uncomfortable symptoms, then call 911. And if symptoms don’t improve with resting for a few minutes, you faint, or symptoms worsen, then call 911.” In these cases, the saying goes: It is better to play it safe.

It’s important to be mindful of heart-related symptoms, but even more important to try and prevent cardiovascular disease and heart attack from the get-go. First up? “The number one preventable risk factor is tobacco and nicotine,” says Mehta. “Quit smoking, and avoid other nicotine products.” Basic, but a big one.

Beyond that, Jean says that the vast majority of prevention revolves around good, solid lifestyle habits—“in spite of the many technological advances” in cardiological medicine. “Focus on eating a diet high in plant-based foods,” she says. “Avoid processed foods, and incorporate exercise into your routine; at least 2.5 hours per week of moderate-intensity exercise is best. Limit alcohol to one drink or less per day, on average.” In addition, she hails the “four S’s” of improving your heart health: “sleep, stress management, self-care, and social connectedness.” You could start by getting some steps in the sunshine, eh? (Think Jean is onto something.)