Heart Attack Symptoms Can Be Different for Women, Says New Study

Think a heart attack automatically means chest pain? Think again-especially if you're a woman.

According to "Symptoms Presentation of Women With Acute Coronary Syndromes - Myth vs. Reality," published online on December 10 in the Archives of Internal Medicine, decades of research show that women often show different signs of a heart attack or other type of acute coronary syndrome (ACS). The National Heart, Lung, and Blood Institute (NHLBI), of the National Institutes of Health, sponsored the study.

Experts reviewed 69 studies, including everything from large clinical trials to one-on-one patient interviews and conducted over the past 35 years, to closely examine the issue of heart attack symptoms in women. Chest pain remains the most frequently observed symptom of heart attack for both men and women. Two-thirds to three-quarters of male and female subjects in the 69 studies did report chest pain during a heart attack.

However, researchers found that 30 to 37 percent of female heart attack patients did not present with chest pain. 17 to 27 percent of male heart attack patients did not have chest discomfort. Older patients are more likely to experience a heart attack without chest pain.

Women are also more likely than men to have cardiac chest pain syndromes other than heart attack, such as unstable angina. Women present with a wider range of symptoms which indicate an acute coronary syndrome. These include back, neck, and jaw pain; difficulty breathing; stomach upset and vomiting; loss of appetite; weakness, dizziness, or fatigue; and heart palpitations.

Recognizing the varied symptoms of heart attack and other types of acute coronary syndrome is crucial. If doctors look only for reports of chest pain, they may misdiagnose the problem and thereby delay the proper treatment. Researchers urge that additional studies must be conducted in order to further examine heart attack symptom differences between men and women.