Heart disease health centre

Women's heart attack symptoms different

22nd February 2012 - Chest pain is the main symptom we're told to look out if a heart attack is suspected, but new US research finds that many women - especially those 45 and under - can have a heart attack without any chest pain or discomfort.

The Royal College of Physicians says the research highlights the need for doctors and the public to be extra vigilant and not rule out a heart attack just because there's been no chest pain.

Heart attack statistics

The NHS says around 111,000 people a year have a heart attack in England alone. Most heart attacks affect the over-45 age group. Men are around two to three times more likely to have a heart attack than women.

In January, researchers from the University of Oxford’s department of public health reported the death rate from heart attacks in England halved between 2002 and 2010. It wasn't clear whether the improvement was down to better treatment or better prevention.

One of the most important factors in surviving a heart attack is getting prompt medical attention, which is why knowing the symptoms is essential.

Worse heart attack outcomes for younger women

The new study published in the Journal of the American Medical Association involved more than a million people.

It found that among heart attack patients, 42% of women and 30% of men arrived at hospital without chest pain or discomfort.

The US statistics showed that although more men than women have heart attacks, a higher proportion of younger women who presented without chest pain died in hospital compared to men without chest pain of the same age.

Smoking was found to be the main cause of heart attacks among younger women, while high cholesterol and narrowing of the arteries was more common as a risk factor in older women.

The researchers say more work is needed to explain the differences in heart attack symptoms  between men and women, and to clarify the situation regarding the way the different patterns of symptoms affect the way patients seek help and whether this affects their treatment.

UK reaction

Reacting to the new research in a statement, Cathy Ross, senior cardiac nurse at the British Heart Foundation, says: "Contrary to popular belief, a heart attack doesn’t necessarily mean dramatic and excruciating chest pains."

She says symptoms vary from person to person, but the most important thing to remember if you think you’re having a heart attack is to dial 999.

"Younger women may need to heed that advice more than most because they appear to be less likely to have chest pains. Their symptoms can be overlooked by inexperienced medical staff because heart attacks in young women are rare."

Dr Kevin Fox, from the Royal College of Physicians' cardiology committee says in a statement: "Although heart attack survival is improving overall, doctors, health care professionals and the public need to be aware and vigilant that women can have a heart attack without the typical chest pain that we all think of as the main symptom."