For decades, heart disease was studied almost exclusively in men. The classic 'crushing chest pain radiating down the left arm' comes from that data — and it describes a male presentation. Women often present very differently, and that difference costs lives.
Women having a heart attack are more likely to report fatigue, shortness of breath, nausea, indigestion, or pain in the jaw, neck, or upper back. Chest discomfort, when present, may feel more like tightness or pressure than pain. These symptoms can start days or weeks before the actual event.
Women are also more likely to have a form of heart disease called coronary microvascular dysfunction, in which the small vessels of the heart don't dilate properly. Standard angiograms often look 'clean' in these patients, which historically led to under-diagnosis.
The most important message: trust your instincts. If something feels wrong and it isn't going away, get evaluated. The cost of a normal ER visit is trivial compared to the cost of a missed heart attack.
Written by
Dr. Sarah Chen
Interventional Cardiologist, ShifaCare Cardiology Hospital
