The signs of a heart attack are similar for everyone. However, females may also be more likely to experience symptoms in the weeks before a heart attack occurs, such as fatigue and sleep disturbances.

Women are less likely to survive a heart attack than men. This may be because the symptoms differ between the sexes. Women are more likely to have a “silent” heart attack or display unusual symptoms.

In addition, female biology creates unique risk factors for heart attack, as some diseases that increase risk, such as polycystic ovary syndrome (PCOS), are not present in male biology.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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Many people expect a heart attack to come on suddenly. However, research suggests that females experience symptoms for several weeks before a heart attack.

An older 2003 study of 515 women who had experienced a heart attack reports that 80% had at least one symptom at least 4 weeks before their heart attack.

Eight of the symptoms of a possible heart attack are:

1. Chest pain

The most common symptom of heart attack in both males and females is chest pain or discomfort.

People may describe this as:

  • tightness
  • pressure
  • squeezing
  • aching

However, women can experience a heart attack without having any chest discomfort.

Some 29.7% of the women surveyed in the 2003 study experienced chest discomfort in the weeks before the attack. In addition, 57% had chest pain during the heart attack.

2. Extreme or unusual fatigue

Unusual fatigue is often reported in the weeks leading up to a heart attack. A person may also experience fatigue just before the event occurs.

Even simple activities that do not require much exertion can lead to feelings of being exhausted.

3. Weakness

Feeling weak or shaky is a common acute symptom of a heart attack in a female.

This weakness or shaking may be accompanied by:

4. Shortness of breath

Shortness of breath or heavy breathing without exertion, especially when accompanied by fatigue or chest pain, may suggest heart problems.

Some women may feel short of breath when lying down, with the symptom easing when they are sitting upright.

5. Sweating

Excessive sweating without a typical cause is another common heart attack symptom in women.

Feeling cold and clammy can also be an indicator of heart issues.

6. Upper body pain

This is usually nonspecific and not attributed to a particular muscle or joint in the upper body.

Areas that can be affected include:

  • neck
  • jaw
  • upper back or either arm

The pain can start in one area and gradually spread to others, or it may come on suddenly.

7. Sleep disturbances

Almost half of the women in the 2003 study reported issues with sleep in the weeks before they had a heart attack.

These disturbances may involve:

  • difficulty getting to sleep
  • unusual waking throughout the night
  • feeling tired despite getting enough sleep

8. Stomach problems

Some women may feel pain or pressure in the stomach before a heart attack.

Other digestive issues associated with a possible heart attack can include:

The risk of heart attack increases due to falling estrogen levels after menopause.

Postmenopause heart attack symptoms include:

  • pain or discomfort in the arms, back, neck, jaw, or stomach
  • rapid or irregular heartbeat
  • severe chest pain
  • sweating without activity

Risk factors for a heart attack in women include:

  • Age: Those 55 years or older are at greater risk of heart attack. This may be because hormones provide some protection from heart disease before menopause.
  • Family history: Individuals with a male relative who had a heart attack by the age of 55 years old, or a female relative who has had one by 65 years of age, are considered to have a family history of heart attack and are at increased risk.
  • Health status: Certain markers, such as high blood pressure and high cholesterol, increase the risk of heart attack in both males and females.
  • Medical conditions: Those with conditions, including diabetes, obesity, and autoimmune disorders, are more likely to have a heart attack. Diseases such as endometriosis, PCOS, or a history of preeclampsia during pregnancy also increase risk.
  • Lifestyle choices: Using tobacco or stimulant drugs, for example, cocaine or amphetamines, a sedentary lifestyle, or high levels of stress will all increase the risk of heart attack.

The British Heart Foundation recommends all women over 40 years of age have regular checks with a doctor. This helps identify risk factors early so they can receive treatment. Early intervention reduces the chances of a cardiac event.

Anyone who notices the warning signs of a heart attack, such as the following, should contact a doctor immediately:

  • unusual fatigue
  • shortness of breath
  • upper body pain

A doctor will note symptoms, check blood pressure and heart rate, and may order blood tests or use an electrocardiogram to check the heart’s electrical activity. If necessary, a doctor can also order a stress test to assess blockages in the coronary arteries.

Is it a heart attack?

Heart attacks occur when there is a lack of blood supply to the heart. Symptoms include:

  • chest pain, pressure, or tightness
  • pain that may spread to arms, neck, jaw, or back
  • nausea and vomiting
  • sweaty or clammy skin
  • heartburn or indigestion
  • shortness of breath
  • coughing or wheezing
  • lightheadedness or dizziness
  • anxiety that can feel similar to a panic attack

If someone has these symptoms:

  1. Dial 911 or the number of the nearest emergency department.
  2. Stay with them until the emergency services arrive.

If a person stops breathing before emergency services arrive, perform manual chest compressions:

  1. Lock fingers together and place the base of hands in the center of the chest.
  2. Position shoulders over hands and lock elbows.
  3. Press hard and fast, at a rate of 100–120 compressions per minute, to a depth of 2 inches.
  4. Continue these movements until the person starts to breathe or move.
  5. If needed, swap over with someone else without pausing compressions.

Use an automated external defibrillator (AED) available in many public places:

  1. An AED provides a shock that may restart the heart.
  2. Follow the instructions on the defibrillator or listen to the guided instructions.
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Tips for better heart health include:

  • Going for regular health check-ups.
  • Taking steps to manage other health conditions, including high blood pressure, high cholesterol, and diabetes.
  • Quitting smoking, if necessary, and avoiding tobacco in any form. Heart disease risk reduces by 50% just 12 months after someone quits smoking.
  • Losing weight for those who have excess weight.
  • Engaging in at least 30 minutes of aerobic activity every day, such as walking.
  • Eating a balanced diet and visiting a dietitian if necessary for dietary advice.
  • Reducing stress levels.
  • Getting enough sleep.
  • Limiting alcohol intake.
  • , especially stimulants, such as cocaine and amphetamines.

Below are some commonly asked questions about the signs of heart attack in women.

What are 3 warning signs of a heart attack in females?

Women can start experiencing symptoms several weeks before a heart attack, including chest pain, fatigue, weakness, shortness of breath, sweating, upper body pain, sleep disturbances, and stomach problems.

What are the 4 silent signs of a heart attack?

A silent heart attack is a heart attack that has either no symptoms, minimal symptoms, or unrecognized symptoms. People are more likely to have nonspecific and subtle symptoms, such as indigestion, flu, thinking they have strained a muscle in the chest or back, and jaw or upper back discomfort.

What does a mini heart attack feel like in a woman?

A person having a “mini” heart attack, also known as a non-ST elevation myocardial infarction, may experience the pressure-like chest pain, shortness of breath, nausea or vomiting, fainting, fatigue, and sweating.

What is a pre-heart attack?

A pre-heart attack generally refers to the early signs of an impending heart attack.

These signs may occur hours or weeks before. This is especially the case for women, who tend to experience unusual fatigue, sleep disturbance, and shortness of breath in the weeks leading up to a heart attack.

A heart attack is a serious and potentially fatal medical event that requires emergency treatment. Females tend to display different heart attack symptoms than males. They also have additional risk factors.

There are many steps people can take to reduce their risk of a heart attack. Awareness of heart attack symptoms, especially in the weeks before the event, can also improve outcomes and prevent complications.