In a landmark study of 515 women who had survived a heart attack, 95 percent recalled early warning signs in the weeks and months beforehand. The single most common was unusual fatigue, reported by about 71 percent of the women, a finding published in Circulation, the journal of the American Heart Association.
Chest discomfort, long taught as the classic red flag, appeared in only 29.7 percent of the same women in the month before their heart attack.
What this fatigue actually feels like
Women in the study did not describe garden-variety tiredness. They described a heavy, unfamiliar exhaustion that did not lift with a night's sleep and made routine tasks feel outsized. Alongside it, sleep disturbance was reported by 47.8 percent and shortness of breath by 42.1 percent of participants in the month before the event.
A Texas Health cardiology summary describes the sensation as walking through mud, a profound tiredness that makes simple activities feel overwhelming. Because that description also fits burnout, stress or a bad week at work, many women wait. Texas Health reports women take an average of 54 hours to seek treatment, compared with 16 hours for men.
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Why the stakes are so high
Heart disease is the leading cause of death for American women. The CDC reports that in 2023 it was responsible for the deaths of 304,970 women, about 1 in every 5 female deaths. Only 56 percent of US women recognize it as their number one killer.
Part of the gap is that the public image of a heart attack, a man clutching his chest, does not match how many women actually present. Some of these heart attack warning signs women too often mistake for stress or indigestion are subtler than chest pain, including jaw or neck pain, nausea, cold sweats and shortness of breath without exertion.
"Symptoms of heart attack in women can present as chest pain but many times it can also present with other symptoms such as shortness of breath, neck or jaw pain, unusual fatigue or frequent indigestion," Dr. Brandie Williams told Texas Health.
When to call 911
The CDC advises women who develop chest pain or discomfort, upper back or neck pain, indigestion, nausea, extreme fatigue, dizziness or shortness of breath to call 9-1-1 immediately, not to wait and see whether the feeling passes. Every minute matters because heart muscle dies while blood flow is blocked.
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Unusual fatigue on its own is not proof of a heart attack. A heavy exhaustion that will not lift, especially combined with any of the other signs above, is a reason to be seen the same day rather than to push through another week.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.