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to both women and

men—but they don’t always look the same. They’re not as

obvious as you’d see on TV, and that’s true for more women

than men.

Here’s a look at what makes recognizing a heart attack so

important—and why noticing more subtle signs is especially

important for women.

What to look for

What does a heart attack feel like? Chest pain or discomfort

is the most common symptom for both women and men.

The pain may last a few minutes or come and go. Some

people say it feels like pressure, squeezing, or fullness. Or it

may feel like an upset stomach or heartburn.

“But women are more likely than men to have other heart

attack signs,” says Margo Kozinski, MD, a cardiologist with

the Heart & Vascular Cardiology Clinic. Those can include:

■  ■

Shortness of breath with or without chest pain

■  ■

Nausea, lightheadedness, or vomiting

■  ■

Unexplained fatigue that may last for days

■  ■

Back, shoulder, arm, or jaw pain

Women are also at higher risk for silent heart attacks,

according to some studies. This is when symptoms of a heart

attack are so mild that they go unnoticed—or are dismissed

as anxiety.

“Silent heart attacks are just as dangerous as more obvious

heart attacks, though,” Dr. Kozinski says. “Left untreated,

they can cause scarring and permanent damage, raising the

risk of other heart problems.”

So don’t be too quick to dismiss shortness of breath or

lightheadedness as just anxiety. And make sure you tell

medical professionals that you think you’re having a heart

attack, not an anxiety attack.

A supply problem at the pump

Despite women’s more subtle symptoms, the mechanics of

a heart attack are fundamentally the same for both sexes. It

happens when the

heart’s blood supply

is reduced or cut

off, most often

when an artery

becomes blocked.

What usually sets

the stage? Doctors

call it atherosclerosis. It happens when arteries that bring

blood to the heart slowly become clogged with plaque. A

piece of plaque can form a clot that keeps oxygen-rich blood

from reaching the heart.

Without prompt treatment, areas of heart muscle may die

and eventually be replaced by scars. This damage could leave

a heart attack survivor with a weakened heart.

“And a weak heart may not be able to pump blood to the

body’s organs like it should, which could result in other

quality-of-life issues,” Dr. Kozinski says.

Quick treatment can restore blood flow to the heart and

help prevent damage. So be aware of these warning signs for

both yourself and others. If there’s even a slight chance you

could be having a heart attack, don’t wait. Call 911 and get to

a hospital to give your heart the best chance.

Sources: American Heart Association, National Heart, Lung, and Blood Institute


of a heart


It’s different for women

Put your

heart into



Regular exercise is

good for the heart. But

exercising outdoors in

cold weather can lead

to chest pain for people

with heart disease and

can be challenging in

other ways.

To keep moving all


Check the forecast.

If dangerous cold

or windchills are

predicted, take

your workouts

indoors. Jog in

place. Do some

pushups. Use

a workout

DVD or online


Dress in insulating


that you can

remove if needed. Don’t

forget a hat or headband

and gloves. If you start to

shiver, head indoors.

Watch your step.

Icy sidewalks and

other surfaces may be


If you have a heart

problem, seek a doctor’s

advice about cold-

weather exercise.




narrowed by






Margo Kozinski, MD


Heart & Vascular Cardiology Clinic

200 NE Mother Joseph Place

Vancouver, WA



Heart health