Women's Heart Health: Recognizing Unique Risks and Symptoms

Updated February 2026

Heart disease remains the leading cause of death for women in the United States and worldwide, yet too many women still don’t recognize it as their greatest health threat. Cardiovascular disease claims nearly one in three lives globally, and in the U.S., it continues to take more women’s lives each year than all cancers combined. Despite these sobering statistics, women are more likely to experience delays in diagnosis, differences in treatment, and symptoms that don’t always match the “classic” signs many people expect.

As a cardiologist, I see firsthand how heart attacks in women can look and feel different. Chest pain may not be the most prominent symptom. Shortness of breath, nausea, back or jaw discomfort, unusual fatigue, or a sense that something just isn’t right can be the warning signs. Understanding these differences, along with the unique risk factors women face throughout their lives, is critical. The more we recognize that heart disease in women does not always follow the textbook, the better we can prevent it, detect it early, and save lives.

Women's Heart Attack Risk Factors

• Hormonal Changes: Women experience various hormonal changes throughout their lives, such as during pregnancy and menopause. These fluctuations can impact heart health, influencing factors like blood pressure and cholesterol levels.
• Birth Control Pills: Some women using oral contraceptives may be at a higher risk of blood clots and heart-related complications. It's important to discuss the potential risks with a health care provider when considering contraceptive options, particularly if you smoke.
• Pregnancy Complications: Conditions like gestational diabetes and preeclampsia can increase the risk of heart disease later in life. Women who have had these complications should be particularly vigilant about their heart health.
• Autoimmune Diseases: Conditions like rheumatoid arthritis and lupus, which are more common in women, can also affect the heart. Managing these conditions effectively is crucial for heart health.
• Psychosocial Factors: Stress, depression, and social isolation may impact women's heart health differently than men. Emotional well-being is an essential aspect of overall cardiovascular health.

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Unique Symptoms of Heart Attack in Women

While most women will develop typical symptoms that are similar to men, we do see many with more subtle presentations of their heart disease. We emphasize listening carefully to how symptoms manifest and what effect they have had on a woman’s quality of life. This vigilance helps guide the evaluation, testing, and treatment that can lead to better diagnosis and improved outcomes. Symptoms to look for include:

1. Atypical Chest Pain: While chest pain is a common symptom for both genders, women may experience more subtle discomfort, such as aching or burning sensations, rather than intense pain.
2. Shortness of Breath: Women may have trouble breathing without chest pain. This symptom is often overlooked but can be indicative of heart issues.
3. Nausea and Fatigue: Women may experience symptoms like nausea, vomiting, or extreme fatigue, which can be associated with heart problems.
4. Pain in Other Areas: Women may feel pain or discomfort not just in the chest but also in the neck, jaw, shoulder, or upper back.
5. Sleep Disturbances: Insomnia and other sleep issues may be linked to an increased risk of heart disease in women.

Educating yourself about risk factors and symptoms associated with heart health is an important first step toward early intervention and prevention of heart issues. Regular check-ups, a heart-healthy lifestyle, and open communication with health care providers can contribute to better outcomes for women in the fight against heart disease. Empowering women with knowledge about their unique cardiac risks will undoubtedly pave the way for healthier hearts and longer, more vibrant lives.

Paul Boffetti, MD, FACC, practices at Foundation Cardiology.