Heart Health Heart Disease How Cardiac Symptoms Are Different in Women Symptoms Often Don't Follow the Medical Textbooks By Richard N. Fogoros, MD facebook linkedin Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our editorial process Richard N. Fogoros, MD Medically reviewed by Medically reviewed by Yasmine S. Ali, MD, MSCI on January 21, 2020 facebook twitter linkedin Yasmine Ali, MD, is board-certified in cardiology. She is an assistant clinical professor of medicine at Vanderbilt University School of Medicine and an award-winning physician writer. Learn about our Medical Review Board Yasmine S. Ali, MD, MSCI on January 21, 2020 Print Cardiac symptoms are often not the same in women as in men. These differences, if unrecognized by women and their doctors, can present a hazard to women who have heart disease. Hinterhaus Productions / Getty Images In standard textbooks of cardiology, much space is devoted to a description of the symptoms that typically occur with heart disease. In most cases, these "typical" symptoms turn out to be a recitation of the symptoms as they are commonly experienced by men. And while cardiologists (relying on those textbooks) may think about the symptoms of heart disease in women as being "atypical," when you consider that more women are dying of heart disease today than men, it may be statistically more correct to think of men's symptoms as the ones that are "atypical." If you are a woman who is experiencing symptoms that you think might be related to your heart, you need to see a doctor. Here are some of the ways in which the symptoms of heart disease experienced by women can differ from the symptoms experienced by men. Angina Doesn't Necessarily Equal Chest Pain in Women Angina is typically described as a pressure-like chest pain that may radiate to the jaw or shoulder, and in men, that's usually accurate. But many women with angina will report a hot or burning sensation, or even tenderness to touch, that may be located in the back, shoulders, arms, or jaw. And, often they have no actual chest discomfort at all. Any good doctor will think of the possibility of angina whenever a patient (of either sex) describes any sort of fleeting discomfort located anywhere above the waist that occurs during strenuous activity. Doctors really shouldn't be thrown off by "atypical" descriptions. However, because too many doctors persist in believing that coronary artery disease is relatively uncommon in women, they may write such symptoms off as mere musculoskeletal pain or gastrointestinal (or even less forgivably) emotional disturbances. Angina With Normal Coronary Arteries Is More Common in Women Furthermore, women are much more likely than men to experience angina when their coronary arteries appear completely "normal" during cardiac catheterization. These women are often told that their symptoms are due to a gastrointestinal disorder (or worse, that the symptoms are in their head), when in fact they have a significant cardiac problem. Heart Attacks Are Different, Too Heart attacks and acute coronary syndrome may also behave differently in women than in the typical male. Frequently, women having heart attacks will experience nausea, vomiting, indigestion, shortness of breath, or simply sudden and extreme fatigue — but no chest pain. Unfortunately, it is easy for doctors to attribute such symptoms to something other than the heart. Women also are more likely than men to have silent myocardial infarctions — that is, heart attacks without any acute symptoms at all, which are diagnosed only retrospectively when subsequent cardiac symptoms occur. Women Tend to Minimize Their Symptoms Studies now indicate that women tend to complain less about their cardiac symptoms than men, so they may fail to alert their doctors to symptoms that really should not be ignored. Why they tend to do this is pure speculation. Perhaps women are more innately stoic than men, or perhaps they are tired of being told by doctors they're just anxious. Either way, it is important that you tell your doctor about ANY new or disturbing symptom that even remotely might be related to your heart. When Should Women Seek Medical Help For Possible Cardiac Symptoms? Given that cardiac symptoms in women may not follow the textbook, how do you know when you should seek medical help for symptoms that MIGHT be related to your heart? The rule you should follow is really pretty simple — if you think it might be related to your heart, see a doctor. Here are some specific guidelines that might help: Get medical help if you might be having angina and go to your doctor or to the emergency room right away if you have any of the following symptoms: Episodes of pain, pressure, burning or squeezing in the chest, jaw, shoulders, back, or arms, lasting up to 5 to 10 minutes Unexplained episodes of shortness of breath lasting up to 5 to 10 minutes Episodes of palpitations with lightheadedness or dizziness Get medical help if you might be having a heart attack. Call 911 immediately if you experience any of these symptoms: Unexplained shortness of breath lasting more than 5 to 10 minutes Sudden severe nausea, vomiting, or indigestion Sudden sweating for no reason Sudden unexplained extreme fatigue Loss of consciousness or fainting Sudden, unexplained, panicky feeling of doom Again, the key is to listen to your body and follow your instincts. If you experience a symptom that is disturbing to you in any way, which even remotely might be related to your heart, get yourself checked out. If the doctor brushes you off, that's a reflection on the doctor, and not on you. That's also a sign that it's time to get yourself a new doctor, one who will actually do what is necessary to get to the bottom of your symptoms. Was this page helpful? Thanks for your feedback! Did you know the most common forms of heart disease are largely preventable? Our guide will show you what puts you at risk, and how to take control of your heart health. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Lehmann JB, Wehner PS, Lehmann CU, Savory LM. Gender bias in the evaluation of chest pain in the emergency department. Am J Cardiol 1996; 77:641. Mosca L, Manson JE, Sutherland SE, et al. Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Writing Group. Circulation 1997; 96:2468.