We’ve long known that when it comes to heart attack symptoms, men and women are different. While men often have the telltale chest pain, symptoms of a heart attack in women are often much subtler—that’s especially true for young women.
A study published in 2013 in JAMA Internal Medicine found that one-in-five women under the age of 55 will have a heart attack without the telltale chest pain. For this study, the researchers looked at 1,015 patients hospitalized for acute coronary syndrome (ACS), of which 30% were women younger than 55.
What they found is that only 13.7% of these young women experienced chest pain, versus 19% of men. The researchers also found that women who didn’t have chest pain had far subtler symptoms of a heart attack than those who had chest pain.
What Are the Symptoms of a Heart Attack in Young Women?
- Chest (middle, left, or right side) discomfort, pain or pressure
- Upper back discomfort
- Pain or tingling of the jaw, elbow or arm (more often the left arm)
- Throat tightness
- Shortness of breath
- Indigestion, or a feeling that if you could just “burp”
- Nausea or vomiting
- Lightheadedness with exertion, dizziness or vertigo
- Disproportionate sweating with activity
- Sudden profound fatigue
If you have any of these signs and symptoms of a heart attack, don’t shrug them off and don’t let your doctor dismiss these symptoms either. Because the signs of a heart attack in young women can be subtler than they are for men, they’re also two times more likely to be fatal because treatment is often delayed.
Signs of a Heart Attack in Young Women Can Also Be Caused by SCAD
While most heart attacks are caused by plaque buildup in the arteries, for younger women they can also be caused by spontaneous coronary artery dissection, called SCAD.
What is a SCAD heart attack? It’s a heart attack that begins with a tear in an artery which blocks the flow of blood to the heart. SCAD is 90% more common in women than men and causes 40% of heart attacks for women under the age of 50. In fact, the average woman who has a SCAD heart attack is just 42 years old.
What causes a SCAD heart attack? It can occur during childbirth with both vaginal deliveries and C-sections. It can also be associated with arterial problems, such as fibromuscular dysplasia. SCAD can also be familial. In many cases the exact cause of SCAD is unknown, although some patients have reported that they were experiencing extreme physical or emotional stress in the days leading up to the heart attack.
Similar to the symptoms of a heart attack in young women, the symptoms of SCAD can include:
- Shortness of breath, even without exertion
- Intermittent discomfort, particularly on the left side of the chest
- A tight, squeezing feeling in the chest
- Pain in the upper body
- Breaking out in a cold sweat
If you have symptoms of a SCAD heart attack, you want to seek medical attention immediately. Unlike a standard heart attack, which is often treated with a stent, patients with SCAD are often treated with aspirin and anti-platelet medications, followed by cardiac rehabilitation. With prompt medical care, the prognosis for women with SCAD is very good; oftentimes women recover in just a few weeks.
When It Comes to Your Heart Health, Refuse to Take “No” for an Answer
The bottom line is that you need to take the bull by the horns. If you’re a woman of any age and have significant risk factors for a heart attack, or if you have any suspicious symptoms even in the absence of risk factors, get an evaluation—demand it! If you have a family history of heart disease, you want to be twice as aggressive.
Women who have a family history of early heart disease (occurring in immediate family members under age 50) have up to three times greater risk of developing arterial disease than someone without this genetic baggage. Make sure your doctor knows your family’s medical history and orders appropriate screening tests.