Women: Don’t Ignore These Signs of Heart Attack

**By J. Susie Woo, MD, FACC**

Woman Chest PainMarysville resident Wendy Knowles never thought she was at risk for a heart attack, especially since she is only 47 and lives a healthy lifestyle.

But when she recently experienced muscle spasms in her shoulders, throbbing in her arms and jaw and a sense of something sitting on her chest, Knowles knew it was time to head to the nearest emergency department. Feeling alarm over her symptoms proved valid: She was having a heart attack and needed an emergency procedure to save her life.

Knowles was transferred to Virginia Mason. Shortly after arriving she found herself in a cardiac catheterization lab, where an angiogram showed her left anterior descending (LAD) artery was completely blocked. Knowles underwent angioplasty, a procedure in which a small balloon is inserted through an artery — in this case in Knowles’ wrist — and is inflated to open the blockage. Next, Knowles received a wire mesh stent to support the newly opened artery. Cardiac rehabilitation and a new medication regimen followed.

“When my interventional cardiologist told me that my LAD was completely blocked, which is called a ‘widow maker’ since many people suddenly die as a result, it hit me hard,” said Knowles. “Awareness and assertiveness saved my life.”

Heart attack symptoms in women

While chest discomfort is the most common heart attack symptom in women, it may not be the first. For unknown reasons, women’s symptoms tend to be more subtle or atypical.

They can include:

  • Extreme fatigue
  • Squeezing or burning in the chest
  • Severe indigestion or pressure in the lower chest or upper abdomen
  • Pain in the upper back or shoulders
  • Jaw or neck pain
  • Nausea or vomiting
  • Shortness of breath

Intense and unfamiliar symptoms and pain that worsens with exertion, but eases with rest, should be checked out immediately. A sudden, cold sweat or pronounced abdominal pressure would also be reasons for concern. For some women, heart attack symptoms may not surface at once. Instead, they can build over time, weeks or days before the heart attack becomes evident.

If you suspect a heart attack, do not hesitate to seek evaluation, even if you have never considered yourself at risk. Swift action could save your life.

Heart attack risk factors in women

Although heart attack symptoms between women and men can differ, risk factors for heart disease between the sexes are the same.

They include:

  • Diabetes
  • Smoking
  • High blood pressure
  • High cholesterol
  • Being overweight or obese
  • Lack of regular aerobic exercise
  • An unhealthy diet
  • Family history of premature coronary disease

Where a difference exists, however, is that some of these risk factors play a more significant role in the development of heart disease in women than they do in men. For example, a woman who smokes or has diabetes is at greater risk for heart disease than a man with either of these factors.

There are also specific risk factors that affect only women. Females who have high blood pressure while pregnant (preeclampsia) are at increased risk for heart disease later in life. The rate of heart disease in women also increases dramatically after menopause, when estrogen levels drop.


Make time to speak with your health care provider about your individual risk for heart disease. Review your personal and family medical history to better understand your overall risk. And if you suspect you might be having a heart attack, even if symptoms seem vague, don’t ignore them and don’t wait. Seek emergency help right away.

bellevueWoo--Joan--Susie--10Susie Woo, MD, FACC, is board certified in internal medicine, advanced heart failure and transplant cardiology. Her specialties include echocardiography, nuclear cardiology, heart failure and preventive cardiology. She practices at Virginia Mason Bellevue Medical Center and Virginia Mason Hospital and Seattle Medical Center.


  1. […] health efforts are focused on prevention, it’s also important to be aware of and look out for signs of heart trouble. Though chest discomfort is the most common symptom of a heart attack, many patients don’t […]

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