How women can tell if they’re headed for a heart attack

by Carolyn Thomas  @HeartSisters

When nurse-researcher Dr. Jean McSweeney from the University of Arkansas for Medical Sciences interviewed hundreds of heart attack survivors, she discovered something surprising: 95 percent of the women she interviewed actually suspected something was very wrong in the months leading up to their attack.

But even these early warning prodromal symptoms didn’t necessarily send women rushing to the doctor, as reported in Dr. McSweeney’s study published in the medical journal, Circulation.(1)  And for those women who did seek help early, doctors often failed to identify their problems as being heart-related.

If you experience the warning symptoms listed below – especially if the feelings are new, worse, unexplained, or you have other heart disease risk factors – call your doctor.  And if they’re severe, or you have any signs of an impending heart attack, call 911

Dr. McSweeney adds:

“Women die sitting at home. Any E.R. would prefer that you come in and not have a heart attack than have a heart attack at home, waiting to see if you get better.

“We could do a lot to give women longer lives and better-quality lives if we could help them recognize these heart problem signs before the first attack.”

Symptom: Unusual fatigue

♥  As Early Warning: Wake up tired. Difficult to carry out usual activities; gets worse over time.
♥  As Sign of Impending Heart Attack: Overwhelming exhaustion – too tired to do anything.

Symptom: Shortness of breath

♥  As Early Warning: Winded with little exertion. Improves when you stop.
♥  As Sign of Impending Heart Attack: Often the first symptom; continues or worsens.

Symptom: Mood changes

♥  As Early Warning: Fleeting feelings of anxiety for no reason. Goes away.
♥  As Sign of Impending Heart Attack: Anxiety occurs along with shortness of breath and doesn’t let up; what we call a “sense of impending doom”.

Symptom: Digestive changes

♥  As Early Warning: Frequent indigestion.
♥  As Sign of Impending Heart Attack: Terrible heartburn, often with nausea and vomiting.

Symptom: Weakness

♥  As Sign of Impending Heart Attack: No strength – like having the flu.

Symptom: Sleep disturbance

♥  As Early Warning: Trouble falling asleep or staying asleep.

Symptom: Chest discomfort

♥  As Early Warning: Pressure, pain, heaviness, fullness, ache, burning, or discomfort (or like a pulled muscle)
♥  As Sign of Impending Heart Attack: Common, usually through chest or back. May or may not be the “Hollywood Heart Attack”: crushing chest pain, pain radiating down either left or right armCarolyn’s Note: remember that in over 10% of heart attacks in women, there are NO symptoms of chest discomfort at all.(2)

Symptom: Other pains

  As Early Warning: Aching arms and hands; may have numbness or tingling (right, left or both)
♥  As Sign of Impending Heart Attack: Discomfort and/or pain in jaw, upper back, shoulders, neck, right, arms (left, right or both)

Other symptoms

♥  As Early Warning: Headaches and periods of blurry vision
♥  As Sign of Impending Heart Attack: Cold clammy sweat, pale skin


♥  As Early Warning:  Symptoms come and go, but may increase in intensity and number as attack nears.
♥  As Sign of Impending Heart Attack: You may have six or more different symptoms that become more intense and pile on top of one another.

Source:  Cleveland Clinic, American Heart Association, Heart and Stroke Foundation

♥    ♥     ♥

* In Dr. McSweeney’s research, women heart attack survivors identified these early warning prodromal symptoms in the weeks/months before a heart attack:

  • unusual fatigue (70.7%)
  • sleep disturbance (47.8%)
  • shortness of breath (42.1%)
  • chest discomfort (29.7%)

The most frequent acute symptoms reported during a heart attack were:

  • shortness of breath (57.9%)
  • weakness (54.8%)
  • fatigue (42.9%)
  • Acute chest pain was absent in 43% of women during a heart attack

♥    ♥     ♥

(1) Jean C. McSweeney. “Women’s Early Warning Symptoms of Acute Myocardial Infarction”. Circulation. 2003; 108: 2619-2623 November 3, 2003. doi: 10.1161/01.CIR.0000097116.29625.7C

(2)  S. Dey et al, “GRACE: Acute coronary syndromes: Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events”, Heart  2009;95:1 2026


NOTE FROM CAROLYN:  I wrote more about early warning cardiac symptoms in Chapter 1 of my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop (my preference!) or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the code HTWN to save 20% off the list price).


See also:

This is NOT what a woman’s heart attack looks like

How Does It Really Feel To Have a Heart Attack? Women Survivors Tell Their Stories

Is it a Heart Attack – or a Panic Attack?

Too Embarrassed to Call 911 During a Heart Attack?

Yale Heart Study Asks Why We Wait So Long Before Seeking Help in Mid-Heart Attacks



♥  PLEASE NOTE: I am NOT a physician and CANNOT advise you if you are experiencing any of these symptoms. Please see your doctor for a competent medical opinion if you are. 

COMMENTS FOR THIS POST ARE NOW CLOSED.  If your symptoms are unusual for you, do not hesitate to seek immediate medical help.

Read my site disclaimer for more info.


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