Do Women Really Have Different Heart Attack Symptoms Than Men?
According to a recent study published in the Journal of the American Heart Association, women are more likely to experience “typical” heart attack symptoms like chest pain, contrary to previous research and popular belief.
However, regardless of gender, if you experience any symptoms that could hint at a heart attack—like chest pain, pain radiating down either arm, nausea, heartburn, jaw or back pain—seek medical attention as soon as possible.
When it comes to heart attack symptoms, it’s a common belief that men experience chest pain while women experience less obvious signs, like back pain or indigestion. However, recent research published in the Journal of the American Heart Association shows the opposite might actually be true.
In the study, researchers assessed the symptoms of 1,941 patients (of which 39 percent were women) admitted into the emergency department of the Royal Infirmary of Edinburgh in Scotland for acute coronary syndrome—an “umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked,” according to the American Heart Association (AHA).
Of those 1,941 patients, 284 (90 women and 184 men) were officially diagnosed with a NSTEMI heart attack, which is the most common type of heart attack that occurs when there is a partial blockage of the coronary artery.
Researchers then split the heart attack symptoms into two categories: typical or atypical. Typical pain included the presence of chest, arm, or jaw pain with descriptors of dull, heavy, tight, pressure, ache, squeezing, crushing, or gripping, according to the study. Additionally, any presence of right arm, left arm, neck, jaw, or back pain, or nausea, vomiting, sweating, shortness of breath, or heart palpitations was also considered typical.
Atypical pain included the presence of epigastric (heartburn) or back pain, or pain that was burning, stabbing, or indigestion‐like.
Their findings? Chest pain was the most common symptom reported by people of either sex who had a heart attack—about 93 percent of both men and women complained of it.
Contrary to popular belief, men who had a heart attack experienced more atypical symptoms—like epigastric pain (heartburn), back pain, or pain that was burning, stabbing, or similar to indigestion—than women did (41 percent vs. 23 percent).
More women than men experienced more “typical” symptoms, such as nausea (34 percent vs. 22 percent) and pain that radiated to their jaw (28 percent vs. 20 percent) or back (31 percent vs. 17 percent).
Both sexes were pretty much equally as likely to experience pain radiating down their left arm—with 36 percent women and 31 percent men reporting it.
According to Amy Ferry, lead study author and cardiology research nurse at the University of Edinburgh, three things differentiate this study with previous studies that have found that men are more likely to experience “typical” heart attack symptoms.
First, the diagnosis of a heart attack in this study was based on the most recent clinical guidelines, she told Runner’s World. Under the previous guidelines, only 1 in 3 women were recognized as having a heart attack, meaning that many women’s heart attack diagnoses were actually missed under those old guidelines.
Second, Ferry and her colleagues only used patient-reported symptoms from before they were officially diagnosed with a heart attack and did not collect data from medical chart reviews. “This ensures that symptoms are recorded as the patient describes them, and are not subjected to interpretation by the assessing clinician or translated into medical terminology when entered into medical notes,” she said. This shows the symptoms the patients described weren’t influenced by their later diagnoses.
Third, this study included a “broad population” of patients with suspected heart attacks. “Studies that rely on confirmed heart attack populations risk excluding many symptom presentations,” Ferry said.
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However, this isn’t to say that if men and women experience heart attack symptoms that don’t exactly align with what this study found, they’re not having a heart attack.
“Heart attacks can present with an array of symptoms in both men and women,” Ferry said. “The most common symptom is chest pain, but pain can also occur in the arms, neck, back, or jaw. In addition to pain, some patients may experience nausea, vomiting, sweating, shortness of breath, or palpitations. Some patients may experience these symptoms without pain.”
While chest pain still remained the most common heart attack symptom for women and men, 41 percent of men and 23 percent of women still experienced atypical symptoms such as heartburn, back pain, or pain that was burning or stabbing. In other words, even though they are not the most common symptoms, they still make up a sizable percentage—and you shouldn’t ignore them even if you aren’t experiencing blatant chest pain.
If you’re experiencing any of these symptoms, you should go straight to the hospital to get checked out.
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