Heart attack symptoms differ in women

The classic picture of a heart attack, characterized by chest-crushing pain, primarily describes men. In many women, the symptoms are different and often go unnoticed, with female heart attacks frequently hidden behind fatigue that is not typically connected to the heart.

Research confirms gender differences

A systematic review of 74 studies, published in April 2023 in Cureus, confirms that women who suffer a heart attack more often present atypical symptoms and seek medical attention later than men. These differences are partly due to biology, as women's hearts are not always blocked in the same way as men's.

Atypical symptoms in women

In women, the warning rarely comes from the chest. The pain instead settles in the jaw, the neck, the back, or between the shoulder blades, sometimes in the upper abdomen. Additional symptoms include nausea, shortness of breath at rest, cold sweats, and sudden exhaustion. These signals are often mistaken for fatigue, a digestive problem, or stress, leading to delayed calls for help.

Early signs and delayed diagnosis

The review also notes early signs in many patients, including unusual fatigue that develops in the days before the event. As a result, the heart attack occurs when it had been developing for some time, without anyone having thought of the heart. Even at the hospital, these unusual presentations can confuse the diagnosis, as the electrocardiogram sometimes misses the warning.

Different causes in men and women

In men, the crisis most often arises from the sudden blockage of a large coronary artery, when a fat plaque ruptures. In women, the problem is more likely to be located in the tiny vessels that supply the heart, where the blockage is less obvious and harder to detect.