Ask an Expert: Women's heart attack symptoms and what to do

Q: I’ve heard that women may experience strange heart attack symptoms, like pain in the jaw, instead of chest pain. Is this true?

Answer provided by Lori Tam, M.D., cardiologist, Providence St. Vincent Heart Clinic-Cardiology and Providence St. Vincent Heart Clinic-Mill Plain:

Yes – women can experience any of the classic heart attack symptoms, but we also may have different symptoms that you might not usually associate with a heart attack. These less-common symptoms, known as “atypical” symptoms, can happen to men, too, but women experience them more often. 

It’s important to be aware of all of the symptoms – not just the most common ones – so you can react quickly in the event of a possible heart attack.

Atypical heart attack symptoms include: 

  • Pain or discomfort in an odd spot, such as the jaw, a tooth, an elbow or the upper abdomen
  • An unexplained sense of doom or anxiety 
  • Sudden weakness or deep fatigue (some women confuse this with the flu) 
  • Nausea 

The classic symptoms include:

  • Pain, burning, pressure or a feeling of heaviness in the chest 
  • A heartburn-like sensation 
  • Discomfort in one or both arms 
  • Shortness of breath 
  • Cold sweatiness 

Any of these symptoms, classic or atypical, may come on suddenly or build gradually over time.

Why would a heart attack cause pain your jaw?

We all have slight differences in the paths that our nerves take from one part of the body to another. Depending on your nerve pathways, you may experience "referred pain" – pain that originates in one part of the body but is felt in another. During a heart attack, although your body's distress signals may originate in the heart, your nerve pathways may refer the pain to your jaw, your elbow, or even a tooth. And it’s not necessarily subtle – the pain can be severe enough to wake you up from a sound sleep. 

If you feel any symptoms, don’t wait – call 911

Women often wait longer than men to seek help for heart attack symptoms. Whether that’s because we don’t recognize the signs, or we think we can wait them out, or we don’t think of heart disease as something that happens to us, women tend to get help later, when we are much sicker. As a result, women don’t recover as well as men, and are more likely to die in the first year after a heart attack than a man is.

So please, don’t wait. If you’re having symptoms of concern or if things just don’t feel right, call 911 and seek medical attention right away. Every minute counts. A heart attack means that the blood supply to your heart has hit an obstacle – nearly always a blood clot due to underlying cholesterol plaques. The longer your heart goes without blood flow, the more heart muscle dies. It’s crucial to restore blood flow before permanent damage occurs. 

While you wait, chew an aspirin

After you call 911, if you have aspirin available, chew one (either one regular adult aspirin or four low-dose chewables) and swallow it with water. Aspirin has anti-clotting properties that can improve blood flow. Chewing it is important to make sure you absorb it as quickly as possible.

Spread the word: it can happen to any woman

Women might get help for heart attacks faster, and recover better, if more of us were aware that heart disease is a woman’s disease. So, help spread the word: 

  • Heart disease is the No. 1 killer of women, as well as men, in the United States. 
  • Heart disease kills more women than all cancers combined.
  • Breast cancer kills one in 31 women; heart disease kills one in three – 10 times as many. 

You can do a lot to lower your risk of a heart attack by exercising regularly, eating a healthful diet, maintaining a healthy weight, and keeping your blood pressure, blood sugar and cholesterol at healthy levels. 

If you live in the Portland area, check out Basecamp, the cardiac prevention and wellness center on the campus of Providence St. Vincent Medical Center, for classes and other resources for heart health. No matter where you live, the American Heart Association and your doctor are great sources for more information.

Updated June 2019