Subtle Differences

Quick Quiz

Which of the following are possible symptoms of a heart attack?

a} You are sweating profusely and have a shooting pain  down your left arm.

c} You feel pain between your shoulder blades.

d} You feel tired, and stairs that were easy to climb last week make you huff and puff today.

e} All of the above

The answer is e} All of the above.

Although chest pain is the most common heart attack symptom for men and women, men tend to have the more dramatic symptoms (A and B), while women tend to have symptoms that are milder (C and D).

Heart attacks are usually the result of coronary artery disease—the most common type of heart disease, according to the National Heart, Lung, and Blood Institute, based in Bethesda, Maryland. A heart attack occurs when the blood supply to the arteries and heart muscle is slowed or stopped due to a blood clot at the site of cholesterol build-up—called plaque—on the artery walls. If a section of the heart is starved of oxygen, cells in the heart begin to die.

In the past, men were more likely to die from heart disease in the United States. But since 1984, more women than men have died from heart disease each year, according to the Women’s Heart Foundation. This may be due a variety of reasons, including doctors not recognizing women’s milder symptoms, and the fact that women generally receive fewer heart disease procedures than men do.

What’s the Difference?

Men and women may experience different heart attack symptoms, but they often have the same reaction to them: denial. Dr. Priscilla Hedberg, a cardiologist with St. Paul Heart Clinic and medical director for HealthEast Women’s HeartAdvantage Program, says that upon informing men and women that they are having a heart attack, common responses include, “It’s not possible that this is my heart, “It really doesn’t hurt that bad,” or “I’m not that uncomfortable.”

“It’s important to recognize that having a heart attack isn’t necessarily a very painful experience,” Hedberg says. “It may just be a tightness or a vague, uncomfortable feeling in their chest.”

Hedberg says that although men and women can have the same type of heart disease, men are more likely to experience a discrete build-up of plaque in a large blood vessel, while women are more likely to have plaque build-up in smaller vessels. According to the New Jersey–based Women’s Heart Foundation, plaque in men’s arteries is commonly distributed in clumps, and plaque in women’s arteries is more often distributed evenly throughout the arteries.