Heart Attack in Women: How to Recognize the Signs

Heart attack is a common and serious medical condition. In Germany, it makes up the second most common cause of death and is accordingly feared. Even though statistics show that fewer women than men are affected, a heart attack is by no means a “man’s disease.” Timely recognition and rapid therapy are important for a good prognosis. The best-known signs of a heart attack include chest pain, weakness and heavy sweating with cold skin. In women, however, a heart attack often manifests itself with atypical symptoms, which is why many sufferers do not interpret the symptoms correctly. We explain here how you can recognize a heart attack in women and what to do then. 13 tips for a healthy heart

Heart attack: what is it?

A heart attack is the undersupply of oxygen to the heart muscle tissue. Most often, this undersupply occurs due to thrombotic vascular occlusion. This means that one or more arteries supplying the heart with oxygen-rich blood become extremely narrowed or even completely blocked by clotted blood, so that no or not enough blood reaches the heart muscle. As a result of the undersupply, the affected tissue becomes necrotic. In other words, it dies if the oxygen supply is not quickly restored. A scar forms at the affected site. This scarred area can no longer participate permanently in the pumping function of the heart. As a further consequence, cardiac insufficiency may develop. The size of the damaged part of the heart depends on the location of the blockage and the time it takes for therapy to begin. For example, in a mild heart attack in which only a small artery is occluded, the subsequent damage is often less pronounced. In most cases, the cause of a heart attack is coronary artery disease. In this case, the vessels are slowly and progressively narrowed by calcification. A heart attack occurs, among other things, when these calcifications become loose (for example, during heavy exertion) and activate blood clotting.

What are the first signs of a heart attack in women?

An early warning sign of a heart attack – in both women and men – is so-called angina pectoris. Angina pectoris is a dull pain behind the breastbone, often accompanied by a feeling of pressure or tightness in the chest. It is caused by physical exertion or stress. Angina pectoris is an early sign of hypoxia due to coronary artery disease with vasoconstriction, which can progress to a heart attack. Thus, it is a harbinger of a heart attack.

How do you recognize a heart attack?

A typical first sign of a heart attack in both sexes is more severe pain behind the breastbone, perceived as crushing, compared with angina. Frequently, this pain can radiate. Classically, it radiates to the left shoulder and arm. Equally, however, the pain can also be perceived on the right side, abdomen, back or neck. In addition, a heart attack is usually accompanied by fear of death. The following symptoms may also accompany it:

  • Palpitations and very fast pulse, respectively.
  • Feeling of weakness
  • Heavy sweating with cold skin
  • Pallor
  • Nausea
  • Limitations of consciousness

What are the symptoms of a heart attack in women?

The above warning signs occur in both men and women. However, women are more likely to experience atypical symptoms. For example, women more often suffer from pain that is not mainly felt in the chest. Frequently, women report pain in the upper abdomen, upper back, arms, and jaw and neck. Also, increased fatigue, shortness of breath, gastrointestinal symptoms such as vomiting and diarrhea, and heart palpitations are more common in women than in men. Symptoms may also be much less severe than in men.

What to do if you suspect a heart attack.

It is important to recognize the symptoms and take them seriously. It is important to seek medical help as soon as possible. Going to the hospital yourself is not advisable. In the case of an acute heart attack, life-threatening complications can occur, which a summoned emergency medical service can treat quickly and expertly. Women often tend to call the ambulance late because of the atypical symptoms.This significantly worsens the further course. The faster a heart attack is recognized and treated, the less heart muscle tissue remains permanently damaged. Contrary to rumors circulating on the Internet, coughing does not help against a heart attack, by the way.

Tests for suspected heart attack

To diagnose “heart attack,” the health care provider will first perform a physical exam and listen to the heart. An electrocardiogram (ECG) is then taken. The ECG records the excitation currents that cause the heart to beat. The ECG may – but need not – be altered and can already give an indication of where the vessel occlusion is located. A blood analysis is helpful if the ECG is inconclusive and allows conclusions to be drawn about the time course of the infarction. Substances detectable in the blood that indicate a heart attack include troponin, myoglobin and creatine kinases. Other medical conditions that damage the heart can also produce similar diagnostic images, such as myocarditis. However, the examining physician can usually tell the difference between myocarditis and a heart attack from both an electrocardiogram and a blood test. An ultrasound and x-ray can also help distinguish between myocarditis and a heart attack. In addition, myocarditis can be caused by other diseases (for example, rheumatoid arthritis or radiation for cancer). In the presence of these diseases, it is important to also think of myocarditis when heart attack symptoms are present. If, despite all examinations, it is unclear whether it is a heart attack, a cardiac catheterization is performed, which is used to treat the heart attack.

Treatment of heart attack

What the exact treatment of the heart attack looks like depends on the one hand on which symptoms occur and on the other hand on the duration since the onset of the symptoms. The goal of myocardial infarction therapy is to eliminate the vascular occlusion as quickly as possible. This is the only way to minimize the tissue damage caused by the insufficiency of blood supply. The therapy recommendations do not differentiate between men and women. Nowadays, the constriction is usually dilated with a small balloon during a cardiac catheterization (percutaneous transluminal coronary angioplasty, balloon dilatation). A vascular prosthesis made of medical wire in the form of a tube, a so-called stent, is then inserted directly to prevent the vessel from closing again. Medication can be used to promote the dissolution of the blood clot. However, this procedure is used less frequently today.

What happens after a heart attack?

Following acute therapy, intensive follow-up care takes place. To prevent another heart attack, medications are prescribed to thin the blood and make it easier for the heart to work. Risk factors are also identified. With lifestyle counseling and the right medication, these risk factors should at best be eliminated. Follow-up treatment in a rehabilitation clinic, known as rehab, is also part of the aftercare. It is intended to help patients get back to everyday life. Unfortunately, these rehab treatments are often less well received by women than by men and are also prescribed less frequently.

Major risk factors in women

Various factors play a role in the development of coronary heart disease and, in its aftermath, myocardial infarction. In women, these are particularly important:

For the most part, women do not suffer heart attacks until they are older, because the high levels of estrogen before menopause are protective against coronary heart disease through their influence on lipid metabolism and blood pressure. However, the risk for myocardial infarction increases, especially in young women, when they are exposed to the above risk factors.

Heart attack in young women

In young people, larger tissue areas are often affected by a heart attack, and the consequences are correspondingly more severe.This is because young people are less likely to have so-called collaterals. Collaterals are arteries that can supply a certain area in a roundabout way. These occur when occlusions form slowly, for example in the case of slowly progressing vascular calcification in old age. The tissue then notices that it is receiving little oxygen and sends signals that lead to new vessel formation. If there are no collaterals, a larger tissue area is affected by vascular occlusion. The risk of heart attack is particularly increased in young women if they are also taking the pill and are exposed to other of the risk factors already mentioned. The pill alone increases the risk in young women only slightly.

What is a silent heart attack?

When a heart attack is not accompanied by the pain described above, it is called a silent or silent infarction. Silent infarctions often occur in very old patients or people with diabetes. In them, nerve damage is common, so that pain can no longer be perceived. A silent heart attack is sometimes noticed by other symptoms that may accompany a heart attack. These include:

  • Sudden shortness of breath due to pulmonary edema (fluid buildup in the lungs) originating from the heart
  • Low blood pressure, weakness and loss of consciousness
  • Confusion
  • Cardiac arrhythmia
  • Vascular occlusions in the extremities, i.e. the arms and legs

A medical clarification of the complaints should be made in any case. However, these warning signs are not specific for a heart attack and can also indicate other clinical pictures.

How can women prevent a heart attack?

You can prevent a heart attack by avoiding risky behaviors. Eating a healthy diet, exercising regularly, and not smoking can prevent many of the risk factors listed above and counteract other diseases besides a heart attack. What is your heart attack risk?