Danger Signals

Because many women don't even know that they have heart disease, it's important to know the warning signs and when it's time to see your doctor. If you know what symptoms to look for, you can work with your physician to treat them early.

Nausea, fatigue, and shortness of breath are some symptoms of heart disease in women, but they can also signal anxiety or stress. In a Gallup survey, 88 percent of primary care physicians were not aware that women's heart-attack symptoms might differ greatly from men's symptoms. In addition, emergency room (ER) physicians miss the signs of a heart attack much more often in women under 55 than in men under 55, according to a recent study published in the New England Journal of Medicine.

Heart attack warning signs in women:

Uncomfortable pressure, fullness, squeezing or pain in the chest that lasts more than a few minutes, or goes away and comes back
Pain that spreads to the shoulders, neck, jaw or arms
Chest discomfort may also be experienced in the upper back between the shoulder blades
Chest discomfort with lightheadedness, fainting, sweating, nausea or shortness of breath

Less common signs in women:

Atypical chest pain, stomach or abdominal pain
Unexplained weakness, fatigue or anxiety
Palpitations, cold sweat or paleness
Shortness of Breath (often associated with signs listed above)

Because women's symptoms are often misdiagnosed, they are far less likely to be treated with aspirin, beta-blockers, and other heart-attack prevention medications. Cardiac catheterization tests are ordered at a much lower rate for women than for men.

Your best defense is knowledge. Learn as much as you can about your own heart health and take an active role in your health care.

References:
1. "Panic Attack or Heart Attack? Responding to Atypical Symptoms of Heart Disease," Women's Heart Foundation, 2000.
2. "Clinical Decisionmaking: Missed Diagnosis of Heart Attack or Angina in Two Percent of ER Patients Is Usually Due to Atypical Symptoms," Agency for Healthcare Research and Quality, 2000.