Unless you’ve experienced one firsthand, most of our knowledge of heart attacks comes from the movies. Not only is this unlikely to be a medically accurate depiction, but chances are it also misses a key detail: Men and women broadly experience heart attacks differently. Female symptoms of a heart attack can be very different to those experienced by men.

Many people are shocked when they realise women are less likely to experience “common” symptoms of heart attack, like chest pains. With this in mind, we spoke to the experts to see how women experience heart attacks differently to men.

Female symptoms of a heart attack

Female heart attacks A caucasian senior woman in a doctors office.  She has white hair and is wearing a blue top.  She is sitting in the examination room with an asian nurse holding a clipboard.  She is holding a hand to her chest and looking uncomfortable.  She is experiencing chest pains.  The nurse is touching the patients shoulder to comfort her.

Cardiologist and associate medical director of cardiovascular diagnostics at Abbott, Gillian Murtagh puts it simply: “Structurally, men and women’s hearts are built the same, but when the heart is in trouble, the outside signs vastly differ by gender.”

This means women have a history of being underdiagnosed and undertreated for heart disease. Murtagh says: “Chest pain is a heart attack symptom for both sexes, but men more than woman experience the effect.”

Women are more likely to experience subtler symptoms like intense fatigue after everyday activities, spontaneous shortness of breath or sweating without exertion, pain in the neck, back or jaw, or an inexplicable cold, clammy feeling.

heart attack women Mature woman suffering from backache at home. Massaging neck with hand, feeling exhausted, standing in living room.

Cardiac nurse for the British Heart Foundation Philippa Hobson says: “Women tend to brush off symptoms as they may not get the symptoms we associate with heart attacks (like we see on TV with the dramatic clutching of the chest and collapsing on the floor).”

Because the warning signs most commonly experienced by females are “soft”, they less likely to seek medical help.

Common signs of a heart attack in women and men

  • chest pain or discomfort that comes on suddenly and doesn’t go away. This may feel like pressure, tightness or squeezing
  • pain that spreads to one or both arms, neck, jaw, back or stomach
  • feeling sick, sweaty, light-headed or short of breath.

Less common signs of a heart attack in women

Heart attacks appear to strike suddenly but warning signs can be experienced in advance. Research shows that women experience symptoms for several weeks before a heart attack including:

  • unusal fatigue when not exerting yourself
  • sudden sweating or shortness of breath without exertion
  • feeling cold and clammy
  • feeling weak or shaky
  • feeling anxious
  • upper body pain
  • sleep disturbances
  • indigestion, heartburn or stomach pain

Women and heart attacks: how women are treated differently

Hobson thinks there is inherent sexism at play, saying: “Heart attacks are classically thought of as a ‘man’s disease’.” This means we’re more aware of the symptoms that affect men (like chest pains) and women might have a harder time convincing themselves or medical professionals they’re having a heart attack.

Heart attack symptoms women Female with chest pain. Senior woman suffering from heartburn or chest discomfort symptoms.

“If women do go to hospital their symptoms can be brushed off as being an anxiety/panic attack,” Hobson explains. This means they might not get the treatment they need. “Early detection of a heart attack is vital as heart muscle can be affected quickly and become permanently damaged,” Hobson says. Not only this, but she adds: “If an initial heart attack is missed, there is a much higher risk of having another.”

Because the symptoms of heart attack are less obvious for women, Murtagh thinks biomarkers become even more crucial in diagnosis. She says: “If doctors suspect a heart attack, they can conduct a test to measure troponin proteins in the blood. The proteins are released by the body when the heart muscle has been damaged, such as when a heart attack occurs. The more damage to the heart, the greater the amount of troponin in the blood.”

Signs of a heart attack in women

For MedicSpot GP Dr Sufian Ali, it’s all about preparation. “Most women do not plan for the event of a heart attack, but getting immediate care is crucial to lessen the damage caused,” he says.

Heart attack symptoms women Female doctor assisting a senior woman in the street

“If you believe you might be in a similar situation where you are experiencing symptoms of a heart attack without chest pain, it is important to immediately dial 999 for an ambulance. Do not attempt to drive yourself or others to the hospital due to the high risk of sudden irregular heartbeats. This is important as only an ambulance will be equipped to revive you if your heart were to suddenly stop beating.”

He also urges women not to downplay their pain, and get help the second they suspect something might be wrong. “Paramedics would rather be called out to find you have made an honest mistake than for it to be too late to save a person’s life,” he says.

What to do if someone is having a heart attack

Would you know what to do if someone around you suffered a heart attack? Chances are you have a loose idea from what you’ve seen in the movies, but that unfortunately isn’t quite enough.

Luckily, St John Ambulance is here to show you the ropes. Hopefully you won’t need to put this knowledge into action, but better safe than sorry (and you’ll also be winning if it comes up in a pub quiz). For example, do you know what the four Ps are? Or what the best way to support the sufferer is?

Take a look at this video so you’re sure of the answers.

Learn 10 simple, everyday tips to live well for longer.