Jaw pain. A queasy stomach. Sudden shortness of breath while doing nothing. Extreme fatigue that has crept in over days or weeks.
These are among the warning signs of a heart attack in women, and they are the very symptoms most likely to be brushed off as stress, the flu, acid reflux or simply getting older.
The American Heart Association lists chest pain or discomfort as the most common heart attack symptom in women, described as uncomfortable pressure, squeezing, fullness or pain in the center of the chest.
But the discomfort can also settle in one or both arms, the back, the neck, the jaw or the stomach. Some women describe an upper back pressure that feels like a rope being tied around them.
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Alongside the classic chest sensation, women often report shortness of breath with or without chest discomfort, breaking out in a cold sweat, nausea, and lightheadedness.
The AHA also flags a set of symptoms it calls less typical, including anxiety, upset stomach, shoulder or back pain, and unusual tiredness or weakness.
Fatigue that appears days before
The National Heart, Lung, and Blood Institute notes that feeling unusually tired for no reason, sometimes for days, is more common in women.
That drawn-out warning sign is one of the reasons a heart attack in a woman is easy to mistake for a bad week rather than an emergency.
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Heart disease is not a peripheral risk. It is the leading cause of death for women in the United States and was responsible for about 1 in every 5 female deaths in 2023, according to the Centers for Disease Control and Prevention.
Only about 56 percent of women recognize that heart disease is their number one killer.
Why the signs get missed
Part of the problem is medical, not personal. In a 2026 scientific statement published in Circulation, the American Heart Association warned that premenopausal women with acute coronary syndrome, the umbrella term for heart attacks and unstable angina, are less likely than men to undergo cardiac catheterization or receive guideline-directed treatment.
Their symptoms are frequently misattributed to noncardiac causes, delaying care.
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Cleveland Clinic interventional cardiologist Jacqueline Tamis-Holland, one of the statement's authors, said the goal was to give physicians the information they need to diagnose the underlying disease and manage individual patients throughout their hospitalization and after discharge.
Cardiologist Jennifer H. Mieres of Northwell Health has long pushed the same point in AHA guidance for both doctors and patients.
"In women, we have to expand that to include neck pain or sometimes just dizziness and nausea with something that feels like heartburn," she said.
What to do if it happens
The single most important step is not to wait it out.
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The AHA is blunt that even subtle signs can be deadly if help is delayed, and it urges anyone with these symptoms to call 911 and get to a hospital right away rather than drive themselves.
Being able to name the less obvious symptoms before a crisis matters. Jaw or neck pain, sudden shortness of breath, cold sweats, nausea, back pressure and days of unexplained exhaustion are not, on their own, proof of a heart attack. But in combination, or when they arrive out of nowhere, they are worth taking seriously enough to be checked by a doctor.
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