Women’s heart attack symptoms can be different from men’s, but several symptoms are frequently shared by both, according to a new review of past studies published Monday in the Journal of the American Heart Association.
In women as well as in men, the three most common symptoms of a heart attack are chest pain, sweating and shortness of breath, the study found. Chest pain, for example, occurs during a heart attack in 79 percent of men and 74 percent of women.
“Heart attack symptoms are often labeled as ‘typical’ in men and ‘atypical’ in women,” says Dr. Annemarijn de Boer, one of the study’s authors and a cardiovascular disease researcher at the University Medical Centre Ultrecht in the Netherlands, in a released statement. “But our study shows that while symptoms can differ between sexes, there are also many similarities.”
DeBoer and her co-authors say that the “atypical” and “typical” labels for heart attack symptoms should be dropped.
The importance of knowing the symptoms
The incidence of heart attacks in the United States has fallen dramatically in recent decades due to advances in treatment, lifestyle changes (particularly fewer people smoking) and a greater emphasis on prevention. The chance of dying from a heart attack has also precipitously declined. Today, about 90 percent of Americans who have a heart attack survive, up from 50 percent half a century ago.
But heart attack is still a major cause of death from cardiovascular disease, which kills about 647,000 Americans each year.
The key to surviving a heart attack is recognizing its symptoms and then getting prompt emergency medical care. Past research has shown that women are more likely than men to delay seeking care, often because they don’t recognize that they’re exhibiting symptoms of a heart attack.
De Boer and her co-authors underwent the current review to get a more accurate — and updated — assessment of what the scientific literature says about the differences between how women and men experience a heart attack.
For the review, the researchers analyzed 27 studies involving more than 1.2 million people who had experienced either a heart attack or unstable angina (a condition in which not enough blood flows to the heart, which often leads to a heart attack). The average age of the participants ranged from 47 to 78. The studies were published from 1985 through 2017, and most took place in Europe or the United States.
The findings from the analysis revealed that no heart attack symptom is exclusive only to women or only to men, although women and men differ in their chances of experiencing certain symptoms.
Compared to men, women are more than twice as likely during a heart attack to have back pain between the shoulder blades, 83 percent more likely to have neck pain, 75 percent more likely to have jaw pain, 64 percent more likely to have nausea or vomiting and 36 percent more likely to have fatigue.
On the other hand, women are 30 percent less likely to experience chest pain and 26 less likely to experience sweating than men. Still, those two symptoms — along with shortness of breath — are the leading symptoms of heart attack among women, as they are among men.
Women and men are equally likely to have shoulder pain, arm pain, gastric pain or indigestion during a heart attack.
The researchers did not explore the reasons for these differences in symptoms, saying that will need to be done in further studies.
“Previous research has shown sex differences in how heart attacks occur in the body,” de Boer points out, “but it is uncertain how or whether this relates to symptom presentation.”
Limitations and implications
The studies used in the analysis varied in several important ways, including how they collected symptom information. Some used medical records; others interviewed patients. Each method could have introduced bias into the findings.
Still, the findings across all the studies were consistent. In addition, the results from newer studies did not significantly change those cumulative findings.
“Symptoms of [heart attacks] should no longer be labeled as “typical” or “atypical” for women and/or men,” the researchers conclude.
And when the focus is on the differences in heart attack symptoms between women and men, it’s important to not lose sight of the fact that there is a large overlap, they add.
Both women and men should know all the possible symptoms of a heart attack — and seek emergency medical care no matter which ones they’re experiencing.
FMI: You can read the study in full at the Journal of the American Heart Association’s website. For a review of heart attack symptoms, go the American Heart Association’s website.