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Why Women Experience Heart Attack Symptoms Differently Than Men

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Why Women Experience Heart Attack Symptoms Differently Than Men

Oct 08, 2024

A heart attack affects both men and women, but the symptoms can present differently. Many women may even dismiss the signs. Cardiologist John Ryan, MD, discusses why women's symptoms tend to differ, which warning signs they should pay attention to, and why heart disease should not be seen as solely a men's health issue.

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    Interviewer: Did you know that when women have heart attacks the symptoms are different from men? True. You're going to find out more about that next on The Scope.

    I was surprised to find out that heart attack symptoms are actually different in men and women. We're going to learn more about that right now with Dr. John Ryan, he's the director of the Dyspnea Clinic at the University of Utah. Men and women, heart attack symptoms are different, is that true?

    Heart Attack Symptoms in Women

    Dr. Ryan: It's true to a certain extent, so the traditional concept we have of heart attacks being the crushing chest pain, hand on your chest, sweating, vomiting, and presenting to the emergency department and be found to have a heart attack, is seen more commonly in men, however, part of the issue is is that women also experience these, but tend to ignore them more. So yes, they have the symptoms, but they just tolerate them better or dismiss them as being a heart attack, because many women don't feel that they're predisposed to a heart attack.

    Interviewer: So for example, if you were to ask somebody what kind of pain you're feeling, one person might say it's a level ten, same amount of pain...

    Dr John Ryan: Yes, exactly.

    Interviewer: ...number five, women are doing the same thing with these symptoms.

    Dr. Ryan: Exactly, yeah, so there's a tendency to dismiss the symptoms, so therefore the symptoms oftentimes need to be more severe or more advanced before a woman presents with them, and then by the time they're more severe and more advanced, they're then different, so instead of having left-sided chest pain or pain radiating down the left arm, they now have central chest pain and it's radiating down both arms. So that's what ultimately can make the syndromes different. Also, women often don't feel that they should have heart attacks.

    Interviewer: They don't have time.

    Women's Heart Health

    Dr. Ryan: Not only do they not have time, but it's a problem that men have. This is a serious misconception because cardiac heart disease is the biggest cause of death for women in the United States.

    Interviewer: Which is a surprise to a lot of people.

    Dr. Ryan: Surprise to a lot of people and it's an important public awareness issue so therefore when women again, when they get their chest pains, or their symptoms from the heart attack, not only do they tolerate it more than men, but also they dismiss it as being a heart attack, sure, sure, why would I be having a heart attack, I'm a woman.

    Interviewer: Sure.

    Dr. Ryan: I don't have heart disease.

    Interviewer: Why do women dismiss, I mean, what is it about a woman's body that they tolerate it more? Any idea?

    Dr. Ryan: Probably a pain threshold issue.

    Interviewer: We've heard that before.

    Dr. Ryan: Exactly, yeah, women often claim to have a higher pain threshold than men, and that's probably true, and in this, and that's a very, that's an advantage, but ultimately that ends up hindering people in terms of presenting when they are having their heart attack. So that's probably the issue.

    Are There Different Types of Heart Attacks?

    Interviewer: The symptoms are the same but different, they experience them differently, but at the end of the day, are heart attacks different?

    Dr. Ryan: So the heart attacks are still associated with significant morbidity, significant mortality and so in that regard they are just as ominous and just as sinister. And the pains, again, the classical pains that people get or that people are taught, is that the central chest pain or the left-sided chest pain, radiating down into the left arm, women often times don't describe this as pain but will describe it as a pressure or a tightness in the chest, all of which are various adjectives that really impact how you perceive pain and again that reflects how you perceive pain. But ultimately the prognosis is still serious, still ominous, and still needs to be treated, taken very seriously and women need to be aware of the fact that they are as likely to experience cardiovascular events as men.

    How to Prevent a Heart Attack

    Interviewer: Is there a takeaway that you would have?

    Dr. Ryan: Although we want to see patients when they're having heart attacks, we want to prevent patients from having heart attacks altogether, so the more important aspect would be for women to be proactive in order to prevent events, so doing exercise, eating healthy, having heart-smart diets and trying to, staying on top of their blood pressure, cholesterol and so on so that we don't end up seeing them when they've had a heart attack.


    updated: October 8, 2024
    originally published: February 7, 2014