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Home    For Our Community    HealthSense    Podcasts    Women's heart attack symptoms can be hard to diagnose
Women's heart attack symptoms can be hard to diagnose


Women often exhibit symptoms of a heart attack differently than men. Instead of chest pain, they might experience fatigue and shortness of breath, making it difficult to diagnose. If you experience chest discomfort, nausea and sweating, pain in your arm or shortness of breath, call 911 immediately. Don't ignore the signs of a heart attack.

Yvette Mitchell: Welcome to HealthSense, brought to you by CoxHealth, striving to be the best for those who need us. I’m Yvette Mitchell. According to the Centers for Disease Control, heart disease is the leading cause of death among men and women in the U.S. But many times, men and women have different experiences with the disease, especially when it comes to symptoms of a heart attack. Mary Yocum is a staff nurse in cardiopulmonary rehabilitation at Wheeler Heart and Vascular Center at CoxHealth. Thank you, Mary, for joining us.

Mary Yocum: Thank you for having me.

YM: Tell us a little bit about the cardiac rehab department at CoxHealth.

MY: The cardiac rehab department is there for patients who have had a heart attack, who have had bypass surgery, who’ve had valve replacements or other heart issues, and they’re there to address educational issues, help them to learn a more heart-healthy lifestyle, and also to exercise and increase their strength and endurance and get back to a normal lifestyle.

YM: When do you first have contact with those patients?

MY: We first have contact when they are in the hospital, after their heart attack or their bypass surgery. We try and talk to them and inform them of what has happened and inform them of what heart disease is, and then talk to them about risk factors for heart disease and how they can change their lifestyle and become more heart healthy.

YM: You work with both men and women. Do the stories you hear them tell about their heart attacks differ?

MY: Yes they do. Women do have more fatigue, they have more shortness of breath and they’re harder to diagnose with their symptoms than men. They can have the same symptoms, they can have the chest pain going into their left arm and into their back, but a lot of times their pain is more generalized. So it’s difficult for the doctor to really figure out what is going on with that woman.

YM: So it would be probably difficult for women to understand what’s going on if it’s hard to diagnose specifically, because a lot of those things you talked about – fatigue, shortness of breath – that could be a variety of health issues.

MY: It definitely could and it is hard for women to realize what is going on. But if they do have more fatigue, something unusual that is going on, they definitely need to talk to their physician. It’s really important to have a physician that you can have a good rapport with, that you can visit with who will listen to you, and you feel comfortable telling them about what is happening to you.

YM: Now how long can those symptoms continue before a woman has a heart attack? Is it a short span or it could be months?

MY: It can be months. We have had women in our program that have been having fatigue for three, four, five months, and it just gets worse and worse and worse. But they really don’t have anything for a few months before they have experienced the fatigue and the shortness of breath, whatever symptom they have.

YM: So those are early warning signs. We all need to be in tune with our bodies a little more to understand. I found an interesting study from the National Institutes of Health that showed that unusual fatigue was the most common symptom a woman experienced before a heart attack, and then the most common symptom during a heart attack was shortness of breath. So it could be different before those months, before those days before that they experience during a heart attack. I thought that was interesting.

MY: Right. And everybody is a unique individual, so again, definitely listen to your body and really pay attention to fatigue. Fatigue is a really important symptom for a woman to notice.

YM: So talking about cardiac rehabilitation, that program after a person has a heart attack – does everyone need to go through cardiac rehabilitation?

MY: It’s a really good idea for everyone who has had something go wrong with their heart to do cardiac rehabilitation, because we talk to them about what some of their individual risk factors are. Smoking is the No. 1 risk factor. Weight loss is important, getting your diabetes under control, getting your blood pressure under control, having a great, safe exercise program. And that’s what they’re also doing while they’re learning heart health – they’re learning how to exercise safely and to increase their strength and endurance in a safe way. After a person has a heart attack, their heart is more irritable and they have an increased chance of having an irregularity that can sometimes be fatal. So we are always monitoring those patients, we watch their blood pressure, we watch their heart rhythms, and it’s just a much safer place that they can learn how to be heart healthy and exercise.

YM: Why is controlling those risk factors so important to a person’s heart?

MY: Some of the ways they affect your heart is, when you smoke, the smoking increases your bad cholesterol, it decreases your good cholesterol, and it changes the oxygen in your blood stream to something that your body really cannot use. High cholesterol will build up in your blood stream and can cause plaques that build up in your arteries, and that can cause a heart attack when those arteries are blocked completely.  You really want to not have a heart attack because that damages your heart muscle. The high blood pressure makes it difficult for your heart to pump against all of that pressure that’s building up against it. Your blood pressure needs to be below 120/80. Weight again makes it more difficult for your heart to pump all the blood through the extra weight, and it just can increase your blood pressure, it can increase your blood sugar and do many other different things to your heart.

YM: So those risk factors are really inter-related?

MY: They are, and they are accumulative. It’s not just one plus one equals two. It’s one plus one equals about three, four, five. So everything that you do to decrease one of those risk factors decreases your risk for heart disease and a heart attack.

YM: I would imagine the best thing would be for a person to attack all of those and not just say, “I’ve cut down on smoking” or “I’ve focused on one.”

MY: That’s right. It’s really important to control all of your risk factors because they all contribute to heart disease. Smoking being the No. 1, and it’s not just cutting down, it is stopping. Stopping smoking is the really only answer to getting rid of that risk factor for heart disease.

YM: Because a lot of people might think that they can just continue their lifestyle they had before the heart attack, but that really shouldn’t happen.

MY: That is really not the safest way. It’s really much safer to go to a cardiac rehab program and be in a safer environment while you’re exercising.

YM: A lot of those things, the risk factors, are important things for all of us to keep in mind to remember that we can change now, so we might not become more susceptible to a heart attack, like weight loss and stop smoking. But it’s difficult for us to change our diet, to change our lifestyle that dramatically. What’s the message that you give to those patients that all of us need to hear?

MY: We just let them know that small steps are very important and to know your risk factors, stop smoking being the No. 1. Talk to your doctor, talk to your pharmacist, talk to a nutritionist about taking small steps and getting rid of some of those risk factors that will increase your chances and hopefully stop you from having a heart attack before it happens.

YM: Well thank you, Mary, for joining us today.

MY: Thank you.

YM: Mary Yocum is a staff nurse in cardiopulmonary rehabilitation at Wheeler Heart and Vascular Center at CoxHealth. And thank you for listening to this HealthSense podcast. Look for other health topics in our podcast library. We’re on the web at Until next time, I’m Yvette Mitchell.

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