While a growing body of evidence points to an increased risk of cardiovascular disease among gender diverse people assigned female at birth, the data is still limited. For the purposes of this article, we’ll be using the term “women” and acknowledge most of the information is based on studies of cisgender populations. Suggestions for maintaining a healthy heart apply to everyone!

Heart disease doesn’t just top the list of health concerns for women; it’s the leading cause of death, accounting for about one in every five.

Forty-four percent of women in the U.S. live with some form of heart disease, and heart attacks are a major consequence of it. Yet, it’s often misunderstood, with heart attacks frequently seen as a men’s issue, especially since women’s symptoms can be more subdued and easily overlooked.

Understanding these signs is an important step toward taking control of your health and acting quickly when it matters most.

How to spot heart attack symptoms in women

When we think of heart attacks, most of us picture dramatic chest pain and a person clutching their heart—thank you, Hollywood. But for women, the reality can be much more subtle. Unfortunately, that subtlety is a big reason heart attacks in women can go undiagnosed or misdiagnosed, attributed to less serious causes like stress or indigestion.

In some cases, women experience a “silent” heart attack, where symptoms are mild or atypical enough to go unnoticed. The consequences? Damage to the heart without realizing it, which can lead to more serious problems down the road. Being able to recognize when something isn’t right—and acting on it—makes a crucial difference.

The subtle signs of a heart attack women often miss

Here’s the tricky part: these symptoms can masquerade as something else entirely, but they shouldn’t be ignored. They are also similar to signs of heart disease in women.

  • Unexplained fatigue: Not your average “I didn’t sleep well” tiredness. This is persistent exhaustion that doesn’t make sense, even if you’ve been lounging on the couch all day.
  • Shortness of breath: Struggling to breathe while doing minimal activity or even at rest is a red flag.
  • Indigestion or nausea: That upset stomach or burning feeling might seem like heartburn, but it could be your heart trying to tell you something else.
  • Neck, jaw, shoulder, upper back or abdominal discomfort: Pain in these areas is often overlooked because we don’t immediately associate them with the heart. Pay attention to persistent or unusual discomfort.
  • Sweating and dizziness: Sudden cold sweats or unexplained light-headedness are more than just annoying; they can be early signs of a heart attack.

These symptoms, especially when some are experienced together, are worth taking seriously. If something feels off, don’t dismiss it as nothing or wait for it to get worse. Too often, we don’t want to be perceived as a bother or “overly dramatic” when something doesn’t seem quite right. You are neither of those things. Trust your gut and seek medical care.

Why early detection of heart attacks saves lives

When it comes to heart attacks, timing is everything. Recognizing the symptoms early and getting medical attention can literally save your life—or at the very least, save your heart from lasting damage. The problem is that many women second-guess their intuition, brushing off symptoms as “just stress” or “something I ate.” Spoiler alert: you know your body better than WebMD does.

Seeking care immediately can prevent a minor issue from becoming a major crisis. Don’t worry about being “wrong.” Healthcare providers would much rather reassure you than treat a preventable emergency. So call your doctor, or if the symptoms are severe, head straight to the ER. Your heart (and your future self) will thank you.

Top heart attack risk factors women need to know

Certain life stages and conditions unique to women can increase heart attack risks.

Hormonal changes

  • Menopause: As estrogen levels drop, so do its protective benefits for heart health, leading to higher blood pressure, cholesterol changes and an increased risk of heart disease.
  • Polycystic Ovary Syndrome (PCOS): This condition brings insulin resistance, inflammation and hormonal imbalances—all of which raise heart disease risks.

Lifestyle factors

  • Stress: Chronic stress raises blood pressure and contributes to inflammation, which negatively impacts heart health.
  • Smoking: Even low levels of smoking can significantly harm women’s heart health, doubling the risk of a heart attack.

Heart disease

  • Heart disease doesn’t just hang out quietly. It works overtime to set the stage for a heart attack. Coronary Artery Disease (CAD), the main culprit, clogs the heart’s blood highways with plaque, narrowing or blocking the flow. If a piece of that plaque decides to rupture, it can trigger a blood clot, cutting off oxygen to the heart and causing a heart attack. It’s like traffic gridlock, but way worse.

While heart disease, particularly CAD, is the most common cause of heart attacks, other conditions can also lead to a heart attack, including:

  • Spontaneous Coronary Artery Dissection (SCAD): A tear in the coronary artery wall, more common in women, especially younger ones.
  • Coronary vasospasm: A temporary tightening of the coronary arteries, restricting blood flow.
  • Stress-induced cardiomyopathy (broken heart syndrome): Triggered by emotional or physical stress, it mimics a heart attack.
  • Blood clots or emboli: These can block blood flow to the heart.
  • Microvascular disease: A condition affecting the small blood vessels, often more common in women.

These less common causes emphasize the need to recognize atypical symptoms and seek medical care promptly, even if traditional heart disease risk factors for women aren’t present.

Heart healthy tips to prevent heart disease

When it comes to heart health, heart attack prevention isn’t just key—it’s everything. Think of it as giving your heart the tools it needs to keep working hard for you, instead of constantly putting out fires. Here’s where to start:

1. Get your wellness screenings.

Routine health check-ups might not be thrilling, but consider them non-negotiable. Regularly monitoring your blood pressure, cholesterol and blood sugar levels can catch potential issues before they escalate. If your provider recommends more in-depth tests or screenings, take them seriously.

2. Make heart-friendly lifestyle choices.

You’ve heard it before, but it’s worth repeating: balanced nutrition and regular physical activity are the cornerstones of heart health. Aim for a diet rich in fruits, veggies, whole grains and lean proteins (bonus points if it resembles the Mediterranean diet). And don’t forget movement that gets your heart pumping.

3. Manage your stress (really).

Stress is inevitable, but managing it is crucial. Chronic stress can wreak havoc on your heart, so find what works for you, whether that’s mindfulness or meditation, yoga, therapy or simply saying “no” more often.

Taking care of your heart isn’t about being perfect; it’s about making consistent choices that support your long-term health.

We love heart health

Recognizing the silent signs of a heart attack unique to women can make a critical difference. By staying informed, making heart-healthy lifestyle changes and prioritizing regular wellness check-ups, you’re not just taking care of your heart, you’re taking control of your future.

Your heart deserves your attention. Your WHA provider can help you identify and make a plan for addressing heart disease risk factors during your wellness visit. But if something feels off, seek care right away. There’s nothing more powerful than being your own best advocate.