Would you recognize the signs if you or someone you know were having a heart attack?
As you learned in Part 2 of this Women and Heart Disease series, a heart attack occurs when an artery supplying the heart muscle is blocked by plaque or a clot. The muscle supplied by the artery begins to die from lack of oxygen. If blood flow is not quickly restored, significant damage to the heart muscle, and even death, can occur. A heart attack is a medical emergency.
We've all watched a television show where a guy, usually in his midlife or older, suddenly clutches his chest, cries out in pain, and collapses to the floor. TV shows and movies usually show the most common signs and symptoms of a heart attack, so that's what we are familiar with, and that's what we look for ourselves. If we saw someone clutching her chest, crying out, and fainting, we would immediately assume "heart attack." And in fact, in both men and women, chest pain is the most common symptom of a heart attack.
But, in women, and especially women in midlife, the signs and symptoms of a heart attack may be different. A woman may not even experience chest pain. Rather, she might have one or more of a group of vague, subtle symptoms that she might not associate with heart attack at all. These symptoms include:
Shortness of breath, with or without chest discomfort. A woman may begin to experience shortness of breath several weeks prior to a heart attack, and it may occur at random times. She could be sitting at her desk and suddenly experience severe difficulty breathing, or find herself short of breath while walking up a flight of stairs that usually presents no problem. Feeling short of breath right after waking up is also a sign something could be wrong.
Chest discomfort or pressure. The most common phrase is "like an elephant sitting on my chest," but the discomfort may be more vague than that. It may feel like squeezing, fullness, or pain in the center of the chest. It may even radiate to the arms, back, neck, jaw, or stomach. The woman may experience pain in the back or the neck or the jaw, but not in the chest.
Nausea. A woman may experience nausea and vomiting and believe she has the flu. Nausea may occur days or weeks before the heart attack.
Breaking out in a cold sweat. Women in midlife may associate this symptom with perimenopausal symptoms.
Dizziness, lightheadedness or fainting. In both women and men, this symptom can be a sign of a heart attack or cardiac arrest. Bob Harper, a fitness trainer, experienced spells of dizziness and even fainting at the gym before he had a cardiac arrest.
Any of these symptoms should prompt a call to 9-1-1 for transport to an emergency room. Women in particular may wait to call, thinking (hoping) it's not serious, but delay can put you in a life-threatening situation. Making the 9-1-1 call early, as soon as you experience symptoms, can save your life.
Even More Vague Symptoms - The Silent Heart Attack
Women sometimes experience a heart attack and don't even know it has happened! But the result is the same - heart damage has occurred. This is the so-called "silent heart attack." However, there are some signs.
Prolonged or Excessive Fatigue. Either before or after a heart attack, a woman may feel excessively exhausted and unable to carry out her usual activities, as the heart muscle is deprived of blood and oxygen.
Indigestion that women may think is the flu, heartburn, an upset tummy, or gastric reflux.
And again, women may experience soreness or pain in the chest or upper back, neck, arm, or jaw that they attribute to a muscle pull.
Because the symptoms can be so vague, women (and their doctors) may think a silent heart attack is just caused by anxiety. Studies indicate that women may experience more silent heart attacks than men, and the silent heart attack causes damage to the heart muscle that may be more dangerous because it is not detected early on.
Feeling of Doom - Many patients experience a feeling of "impending doom," that something is just not right. If you are feeling any of these symptoms, see your physician and request a cardiac asssessment.
Learn more about Women and Heart Health in the Love Your Heart series.