More than 60 million women in the U.S. live with cardiovascular disease, yet many still see heart attacks as “a man’s problem.” The reality is stark: about 37,000 women die from heart attacks every year, and many of those deaths are preventable with earlier recognition and action.

Lori Sepich, 64, had smoked for years and sometimes skipped her blood pressure medication. Still, she never imagined she’d be the one having a heart attack. “The possibility just wasn’t registering with me,” she recalled. Her story is sadly common—and it’s exactly why understanding the risks and symptoms for women matters.

This guide walks you through what makes women’s heart attacks different, how to spot subtle warning signs, and specific steps you can take—starting today—to lower your risk and advocate for yourself in a medical emergency.

Many women underestimate their heart attack risk and delay going to the hospital, which can be life-threatening.

The overlooked problem: Why women’s heart attacks are often missed

For decades, most heart attack research and public messaging focused on men. As a result:

  • Women themselves often don’t think they’re at risk.
  • Symptoms in women can be more subtle or “atypical.”
  • Even healthcare providers may misinterpret early warning signs as anxiety, indigestion, or stress.

“Women are more likely than men to arrive at the hospital after the window where certain life-saving treatments work best,” notes cardiology research published in the American Heart Association’s Circulation journal.

The good news is that awareness is rising. Large studies and updated guidelines now emphasize women’s heart health, and organizations like the American Heart Association and the National Institutes of Health are funding more sex-specific research.


Women’s heart attack risk factors: What really matters

The classic heart-attack risks—high blood pressure, high LDL (“bad”) cholesterol, smoking, diabetes, and family history—affect both men and women. But women also have sex-specific and life-stage-specific risks.

Major risk factors for women

  1. High blood pressure (hypertension)

    Often called the “silent killer,” it damages arteries over time. Lori’s skipped medications are a common pattern—missing pills can cause spikes that strain the heart.

  2. Smoking

    Smoking is particularly dangerous for women, especially those on certain hormonal contraceptives or with migraine with aura. It accelerates plaque buildup and makes blood more likely to clot.

  3. Diabetes and prediabetes

    Diabetes increases heart attack risk in everyone, but its impact is often greater in women. It can blunt classic chest-pain symptoms, making attacks harder to recognize.

  4. High LDL cholesterol and low HDL cholesterol

    Unhealthy cholesterol levels promote plaque deposits in coronary arteries. Some women have genetic conditions like familial hypercholesterolemia that dramatically raise risk.

  5. Family history

    A parent, sibling, or close relative with a heart attack before age 55 (men) or 65 (women) signals higher inherited risk.

Women-specific and under-recognized risks

  • Pregnancy-related complications
    • Pre-eclampsia or pregnancy-induced hypertension
    • Gestational diabetes
    • Preterm birth or low-birth-weight baby

    These are early “stress tests” for the heart and vessels. Women who’ve had them carry higher cardiovascular risk in midlife and beyond.

  • Autoimmune and inflammatory conditions

    Diseases like lupus and rheumatoid arthritis are more common in women and increase inflammation in blood vessels, raising heart-attack risk.

  • Early menopause or surgical menopause

    Losing estrogen before age 40, whether naturally or through surgery, is linked with higher cardiovascular risk.

  • Chronic stress, depression, and caregiving burden

    These don’t just affect mood—research links them to higher blood pressure, poor sleep, unhealthy coping behaviors, and higher risk of heart events.


Heart attack symptoms in women: It’s not always “crushing chest pain”

Many women expect a dramatic, movie-style heart attack: severe chest pain, someone clutching their chest, collapsing to the floor. While some attacks look like that, many do not—especially in women.

Common symptoms women may feel

  • Chest discomfort – pressure, squeezing, fullness, or pain. It may be mild, come and go, or feel like tightness or burning.
  • Shortness of breath – with or without chest discomfort, sometimes during rest or minimal activity.
  • Pain or discomfort in other areas – one or both arms, back, neck, jaw, or stomach.
  • Unusual fatigue – feeling suddenly exhausted doing routine tasks, or extreme tiredness that’s new or “not like you.”
  • Nausea, indigestion, or vomiting – especially if you don’t usually have stomach issues.
  • Cold sweat, dizziness, or lightheadedness.

Women are more likely than men to describe symptoms like:

  • “I felt like I had the flu.”
  • “My back and jaw were aching.”
  • “I couldn’t catch my breath walking across the room.”
  • “I was just overwhelmingly tired for days.”
Middle-aged woman sitting on a sofa holding her chest and looking concerned
Heart attack symptoms in women can be subtle, such as chest tightness, shortness of breath, or unexplained fatigue.

“If something suddenly feels ‘off’ from your baseline—especially chest, back, or jaw discomfort with shortness of breath—don’t talk yourself out of getting it checked,” says guidance from the U.S. Centers for Disease Control and Prevention (CDC).


Lori’s story: “I almost waited too long”

Lori had a busy life, like many women juggling responsibilities. She smoked, had high blood pressure, and sometimes ignored her medications. When she began feeling pressure in her chest and unusual fatigue, she brushed it off as stress and a bad night’s sleep.

Hours later, the discomfort spread into her back and left arm. She still hesitated—she didn’t want to “make a fuss” or overreact. A friend insisted she call emergency services. At the hospital, tests confirmed she was in the middle of a heart attack.

Her cardiology team later told her that the delay could have cost her life or left her with permanent heart damage. Rapid treatment opened her blocked artery and limited the injury.

Lori’s experience mirrors what many women report: symptoms they rationalize or minimize, a fear of being dismissed, and a strong instinct to “push through” rather than ask for help.


How to save yourself: What to do if you suspect a heart attack

In a heart attack, minutes matter. The longer blood flow is blocked, the more heart muscle is permanently damaged. Acting quickly can be the difference between full recovery, heart failure, or death.

Step-by-step: In the moment

  1. Stop what you’re doing and sit or lie down.

    Don’t try to “walk it off” or finish chores. Reduce strain on your heart immediately.

  2. Call emergency services (911 in the U.S.) right away.

    Tell the operator you suspect a heart attack and describe your symptoms and risk factors. Do not delay by calling your doctor’s office first.

  3. Chew aspirin if advised and not allergic.

    If you have no history of aspirin allergy or severe bleeding and emergency operators or your doctor have advised it, chew a regular-strength aspirin (usually 325 mg). Chewing helps it work faster. If you’re unsure or have clotting issues, follow the dispatcher’s instructions.

  4. Unlock your door and keep your phone nearby.

    This helps paramedics reach you quickly. If someone is with you, have them wait outside to direct emergency responders.

  5. Do not drive yourself unless you have no other option.

    If symptoms worsen while driving, you could harm yourself and others. Ambulances can start treatment and alert the hospital before you arrive.

Emergency medical team attending to a patient in an ambulance
Calling emergency services quickly allows trained professionals to begin life-saving treatment before you reach the hospital.

Long-term protection: How women can reduce heart attack risk

Lifestyle changes can’t erase all risk—especially when genetics or past conditions are involved—but they can significantly lower the chances of a heart attack and improve your quality of life. Even modest steps matter.

1. Know your numbers

  • Blood pressure – Aim for what your clinician recommends (often below 130/80 mm Hg for many high-risk adults, based on current guidelines).
  • Cholesterol – Especially LDL (“bad”) cholesterol and HDL (“good”) cholesterol.
  • Blood sugar – Fasting glucose or A1c if you have or are at risk for diabetes.
  • Waist circumference and weight trends – Abdominal fat is more strongly linked with heart risk than weight alone.

2. Take medications consistently

If your clinician has prescribed drugs for blood pressure, cholesterol, or diabetes, taking them as directed is one of the most powerful heart-protective steps you can take. Lori’s story underscores how skipping pills—especially blood pressure medications—can be dangerous.

  • Use a pill organizer or smartphone reminders.
  • Talk openly with your clinician if cost, side effects, or confusion about dosing is getting in the way.
  • Never stop heart medications suddenly without medical guidance.

3. Quit smoking and avoid secondhand smoke

Quitting smoking is one of the fastest ways to reduce heart attack risk. Within a year of quitting, your risk drops significantly; over time, it can approach that of a non-smoker.

  • Ask about nicotine replacement therapies or prescription medications.
  • Combine medication with counseling or support groups—it works better than either alone.
  • Avoid vaping nicotine as a “safe” alternative; research continues to raise concerns.

4. Move your body—realistically

Guidelines typically recommend at least 150 minutes of moderate-intensity aerobic activity per week plus 2 days of strength training. But if that feels out of reach, focus on what you can do:

  • Start with 10-minute walks, 2–3 times a day.
  • Use the stairs when possible, or park a little farther away.
  • Try low-impact options such as swimming, cycling, or chair exercises if joints hurt.
Group of women walking and exercising outdoors in a park
Regular, realistic movement—like daily walks—improves blood pressure, weight, mood, and heart health.

5. Eat in a heart-conscious way

There’s no single perfect diet for everyone, but patterns like the Mediterranean-style eating plan—rich in vegetables, fruits, whole grains, legumes, nuts, and healthy fats—are consistently linked to lower heart risk.

  • Fill half your plate with vegetables at most meals.
  • Choose whole grains (oats, brown rice, whole-wheat bread) over refined grains.
  • Swap red and processed meats for fish, beans, or lentils several times a week.
  • Use olive oil instead of butter for most cooking.
  • Limit sugary drinks and ultra-processed snacks.

6. Protect your heart from stress

Chronic stress, trauma, and depression can raise blood pressure, worsen inflammation, and lead to habits that harm the heart. Women often carry invisible emotional and caregiving loads.

  • Build small recovery rituals—short walks, stretching, breathing exercises, or journaling.
  • Stay connected with friends, family, or support groups.
  • Ask for professional help if you notice persistent sadness, anxiety, or sleep problems.

How to talk with your doctor about women’s heart health

Many women say their heart concerns have been minimized or misattributed to stress or anxiety. Being prepared can help you get the evaluation and follow-up you need.

Before your visit

  • Write down your symptoms: when they started, how often they occur, what makes them better or worse.
  • List all medications and supplements you take.
  • Note your personal and family heart history, including pregnancy complications.

Questions you can ask

  • “What is my risk of having a heart attack in the next 10 years?”
  • “Do I need blood tests for cholesterol, blood sugar, or inflammation?”
  • “Given my symptoms, should we consider tests like an ECG, stress test, or coronary imaging?”
  • “Are my symptoms consistent with angina or other heart conditions seen in women?”

“Patients who ask specific questions tend to receive more thorough cardiovascular evaluations,” report several primary-care and cardiology studies summarized by the National Heart, Lung, and Blood Institute (NHLBI).


Before and after awareness: What changes when women take heart symptoms seriously

Awareness alone doesn’t prevent every heart attack—but it changes how quickly women respond, the care they receive, and their odds of recovery.

Older woman talking to a healthcare professional during a consultation
Regular checkups, honest conversations about symptoms, and understanding personal risk can help catch heart problems early.
Before awareness After awareness
Symptoms dismissed as stress, anxiety, or indigestion. Symptoms recognized as possible heart warning signs.
Delay of hours or days before calling for help. Emergency services called within minutes of concerning symptoms.
Limited discussion of risk factors with clinicians. Proactive conversations about blood pressure, cholesterol, and pregnancy history.
Higher chance of extensive heart damage or complications. Greater likelihood of timely treatment and better long-term outcomes.

You don’t need to live in fear of a heart attack. Instead, think of awareness as another tool—like a seatbelt or smoke detector—that quietly protects you in the background of everyday life.


Trusted resources for women’s heart health

When you’re looking for reliable information, focus on organizations that base recommendations on peer-reviewed research and expert consensus.


Putting it all together: Your heart, your voice, your next step

Women suffer heart attacks, too—and far too many never realize their hearts were at risk. Lori’s story is a warning, but it’s also a reminder that action saves lives: noticing symptoms, calling for help, and following through with long-term prevention.

You don’t have to change everything overnight or become a perfect patient. You only need to take the next right step for your heart.

  • Schedule a checkup to review your blood pressure, cholesterol, and blood sugar.
  • Write down any symptoms you’ve been ignoring and bring them to your appointment.
  • Choose one realistic change this week—walk more, smoke less, eat one more vegetable-filled meal, or set up your medications in a pill organizer.

Most importantly, promise yourself this: if your body sends a serious warning—chest pressure, shortness of breath, unexplained pain in your arm, back, or jaw—you will listen, you will call for help, and you will treat your heart as if your life depends on it.

Because it does—and you are worth that call.