Key takeaways:
Heart attack symptoms can be different for women than for men.
Symptoms often start long before a heart attack.
Women who tell their stories here say they wish they had listened to their instincts.
The kind of heart attack people see in movies is often a man falling to the ground clutching his chest. But women may experience a wide variety of symptoms instead of, or in addition to, chest pain.
Here, three women who’ve had heart attacks talk about what they experienced and how they wished they had listened to their bodies and their instincts.
Some women rationalize away heart attack symptoms
Dina Pinelli — a 49-year-old fourth-grade teacher from Long Island, New York — had a long list of rationalizations when she experienced symptoms before the first of her three heart attacks.
It was April 2020, the early days of the pandemic, and Dina was trying to keep up physical activity as she worked from home. She took regular walks with her dog, Ananda, and friends. But she started to notice it was hard for her to walk and talk at the same time.
Dina thought her discomfort could be COVID-related. She also guessed it might be pneumonia, allergies, bronchitis, or even menopausal symptoms. She was reluctant to seek medical help because of the pandemic and her disbelief that it was anything serious.
Her father had survived a major heart attack in 2005, but she had taken precautions after that to take care of her own health. She had lost 100 pounds, started on a statin to keep her cholesterol in check, and added yoga and meditation to her routine.
Months went by — and breathing became even harder. The weight on her chest was intensifying. One night, in the middle of the night, Ananda licked Dina’s arm until she woke up.
Dina sat up and felt intense pain in her wrists and elbows. Her arms were crossed, and they felt frozen in that position. She rolled her wrists trying to relieve the pain. The pain spread to her back and chest. She couldn’t move and was pouring sweat.
But then, symptoms subsided, and she took two anti-inflammatory tablets and went back to bed. She would later find out that was her first heart attack. She went to urgent care 2 days later, but the provider suspected an asthma attack when Dina told her it was hard to catch her breath. She sent Dina home with a prescription for an inhaler.
The next week, Dina felt she was simply getting out of shape with reduced activity, so she jumped on a treadmill. After a few steps, she draped herself over the bars, feeling the same wrist, elbow, and back symptoms. She waited until the symptoms passed and she could get off the treadmill. Heart attack number two. But again, she didn’t know it.
It happened that the next day was the first day her doctor could accept patients in-person. And after reading the results of her electrocardiogram (which tracks heart activity), she sent Dina directly to the hospital.
The doctor at the hospital put a stent in to restore blood flow after finding out Dina had experienced a complete blockage in a key artery.
A week later, she felt the wrist, elbow, and back symptoms. But this time, she called for medical help and was admitted to the same hospital with what her doctor told her was a third heart attack. There, they put in a second stent to relieve another blockage.
Dina says she never suspected pain in wrists and elbows could be a heart attack symptom.
“Hollywood has done an incredible job of teaching us all what a man’s heart attack is, and I applaud them for that,” Dina said. “However, they’re forgetting about women.”
Swing dancer says it felt like heartburn
For 44-year-old Sharell Weeams of Dallas, the feeling she had for nearly a year before her heart attack was more like heartburn, a burning in her chest when she went up stairs or walked even short distances.
But in November 2021, while she was enjoying her passion of swing dancing into the wee hours, she told her dance partner she suddenly felt very dizzy and exhausted. She quickly collapsed to the floor unconscious and stopped breathing.
Nurses who happened to be nearby first tried cardiopulmonary resuscitation (CPR) and then an automated external defibrillator (AED) to restart her heart before Sharell was taken to the hospital.
The cardiologist she saw first said all tests were normal and was ready to release her.
But Sharell insisted on more tests to find out what had gone wrong. The next day, a specialist in the cardiac catheterization lab found that blockage in her arteries had caused a heart attack, and she underwent a quadruple bypass days later.
Her message to women is “trust your gut.” She added that if you are on medication to lower your cholesterol, stay on it.
Sharell says she knew she had high cholesterol but had gotten lax about taking her medication and regrets it.
Chest pain and swollen ankles were her symptoms
Months before 54-year-old Denise Castille had her heart attack in 2015, she was alarmed by sudden swollen feet and ankles.
A doctor brushed off her worries, she says, saying that she was overweight and the swelling would go down if she lost weight. She changed doctors.
A month after that she began experiencing bouts of chest pain. Again, Denise says, doctors dismissed her symptoms and told her stress was likely the cause. She started recording her heart palpitations on a spreadsheet, but a cardiologist said she didn’t need those notes and told her there was nothing wrong with her heart.
In July 2015 as she was getting ready to fly home from a work trip, Denise had what she describes as massive heart palpitations — the kind of pounding that “takes your breath away.”
She yelled out for a coworker, who saw that Denise’s face coloring had turned gray. The woman called 911, and Denise was taken to a hospital where a stent was inserted.
Denise, who lives in McKinney, Texas, says she was angry about how her misdiagnoses had life-changing effects.
But now, she focuses on how the sequence of events led her to a new appreciation for her life and to a job she loves: teaching cardiopulmonary resuscitation classes. Denise founded a nonprofit organization centered on heart disease education.
Her advice to women is: “Know your body. Trust your instincts.” And if a doctor shrugs off your symptoms, she says, get a referral from someone you trust for a doctor who will listen.
(All three women who talked to GoodRx about their heart attack experiences are American Heart Association volunteers. Dina and Sharell are part of the organization's Go Red for Real Women 2023 class of survivors.)
What does the doctor say?
Patricia Pinto-Garcia, MD, MPH
Medical Editor
A heart attack happens when the heart doesn't receive enough oxygen-rich blood. Without oxygen, the heart muscle starts to die and gets damaged. It’s a serious medical emergency, and the main goal of treatment is to get oxygen back to the heart as quickly as possible to prevent further damage.
It’s true that heart attacks can feel differently to women. This has to do with the fact that in men, heart attacks often develop because of coronary artery disease but women tend to develop heart attacks for different reasons. That means their symptoms can be different and milder, like in the stories above. Women are more likely to experience symptoms like palpitations, trouble breathing, and fatigue.
It also means that the tools used to detect early signs of heart attacks might not work as well for women. So, even if women seek help, initial tests may not show signs of a heart attack. While healthcare providers are aware that signs of heart attacks can be different from person to person, with normal testing results it can be very hard to decide if someone is having a heart attack or a more common illness that also causes similar symptoms.
Sometimes, people experience repeated symptoms before they have a heart attack. These symptoms often happen when the heart is working harder, like during exercise or climbing stairs. If you notice any unusual symptoms during activity, even if they are mild and go away when you rest, it’s important to keep track of them and talk to a healthcare provider. If your symptoms are more severe or don’t go away with rest, you should go to an emergency room.
Remember to always inform healthcare providers about any history that increases your risk of having a heart attack, such as other medical conditions, smoking, or a family history of heart attacks. This information can help healthcare providers decide if further steps are needed to check for a heart attack, even if the initial tests appear normal.
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