Heart Attack Warning Signs in Men and Women

Every 40 seconds, someone in the United States has a heart attack, according to the CDC. Getting treatment quickly can save heart muscle and lives. Yet many people delay calling for help because their symptoms don't match what they expected, especially women.

Knowing the warning signs could help you save your own life or someone else's.

What is a heart attack?

A heart attack (myocardial infarction) happens when blood flow to part of the heart muscle is blocked, usually by a blood clot in a coronary artery narrowed by plaque. Without oxygen-rich blood, that part of the heart muscle begins to die. The faster blood flow is restored, the less damage occurs.

Common warning signs

• Chest pain or discomfort: usually in the center or left side of the chest, lasting more than a few minutes or going away and coming back. It may feel like pressure, squeezing, fullness, or pain.
• Discomfort in other areas of the upper body: one or both arms, the back, neck, jaw, or stomach
• Shortness of breath, with or without chest discomfort
• Cold sweat
• Nausea, vomiting, or lightheadedness
• Unusual fatigue

Heart attack symptoms in women

Chest pain or discomfort is still the most common symptom in women. But women are more likely than men to experience other symptoms, sometimes without obvious chest pain, including:

• Shortness of breath
• Nausea or vomiting
• Pain in the back, jaw, or neck
• Unusual or extreme fatigue, sometimes for days beforehand
• Lightheadedness or dizziness
• Indigestion-like discomfort

Because these symptoms can be subtle, women sometimes delay seeking care or are misdiagnosed. Heart disease is the leading cause of death for women in the U.S., just as it is for men.

Silent heart attacks

Some heart attacks cause mild symptoms or none at all, especially in older adults and people with diabetes. These "silent" heart attacks may only be discovered later on an ECG. That's one reason regular checkups and managing risk factors matter.

What to do if you suspect a heart attack

1. Call 911 right away. Emergency medical services (EMS) can start treatment on the way and alert the hospital. Calling 911 is almost always the fastest way to get lifesaving care.
2. Chew an aspirin if advised. The 911 dispatcher may tell you to chew a regular 325 mg aspirin (or two to four low-dose 81 mg tablets), unless you're allergic to aspirin or have been told not to take it. Aspirin can help slow blood clotting.
3. Stop all activity and sit or lie down in a comfortable position.
4. Unlock the door so emergency responders can get in.
5. Take nitroglycerin if it has been prescribed for you, as directed.

If someone collapses

If a person is unresponsive and not breathing normally, call 911 and start hands-only CPR: push hard and fast in the center of the chest, about 100 to 120 compressions per minute. If an AED (automated external defibrillator) is available, use it; it gives spoken instructions.

Why fast treatment matters

At the hospital, doctors may open the blocked artery with a procedure called angioplasty and place a stent, or give clot-dissolving medication. The sooner this happens, the more heart muscle can be saved. Delaying even an hour can mean more permanent damage.

Know your risk factors

Major risk factors for heart attack include:

• High blood pressure
• High LDL cholesterol
• Smoking
• Diabetes
• Excess weight and physical inactivity
• Family history of early heart disease
• Older age

Managing these risk factors greatly lowers your chances of a heart attack.

Related: stroke warning signs (BE FAST)

• Balance: sudden loss of balance
• Eyes: sudden vision loss or changes
• Face: one side of the face droops
• Arms: one arm is weak or numb
• Speech: slurred or strange speech
• Time: call 911 immediately

The bottom line

Heart attack symptoms aren't always the dramatic chest-clutching moments seen in movies. Learn the signs, especially the subtler symptoms common in women, and don't hesitate: call 911. It's always better to get checked and be fine than to wait too long.