Ask the Doctor: ‘Are the symptoms of a heart attack in women different to those in men?’

“I am a woman in my 50s and though I work long hours at a desk job, I try my best to get my daily steps in. A colleague recently had a heart attack, and I’ve read that symptoms of a heart attack in women can be different to those in men and may not always be the typical pain in the chest and arm. Is this true? What are the symptoms women should be aware of?”

Answer from Professor Robert Kelly, Consultant Cardiology and Lifestyle Medicine, Beacon Hospital, Dublin.

Heart attacks occur in 6,000 people on average in Ireland every year – 70% of these are in men.

If you experience severe central chest pain, with sweating, sickness and possible shortness of breath or heart racing, call 999 and tell them you think you are having a heart attack. If it is a heart attack, they will give you aspirin and bring you to a Specialised Heart Centre for treatment, usually with an angiogram dye test and stent or rarely open-heart surgery. The most important thing that you can do is call 999 immediately. Do not wait around or worse, ignore your situation.

Some people have heart attacks without symptoms. Women may not get typical left-side chest pain that might go into the neck/ jaw or left arm. They may get lesser pain or pain in other parts of the chest, back, shoulder which can be hard to tell if it is the heart or not. But if you are feeling unwell with those symptoms, you are better off to be safe and call for help.

Other symptoms include difficulty breathing, feeling sick and clammy, cold sweats, or being unusually tired. Most heart attacks happen between 4 and 10am.

The best treatment for your heart health to avoid having a heart attack is the below:

• Have a check-up with your GP.
• Check Cholesterol, Lipoprotein a, ApoB levels, Blood sugar, HbA1c.
• Measure blood pressure, body weight.
• Have you a family history of heart disease or strokes?
• Do you smoke or take drugs?
• Do you have much stress? Are you sleeping? What is your diet? Do you exercise?
• Do you have chest pain, breathlessness, palpitations, dizziness, fatigue, ankle swelling?

The GP will measure your risk and may refer you to a Cardiologist for further testing such as a stress test, echo scan to look for damage, CT scan of the coronary arteries to look for plaque/blockages.

You could do a Heart Health Check which includes all of these tests and see a Cardiologist at the same visit. We have a Rapid Access Cardiology Clinic where this is offered.

Following testing, you may require changes to your lifestyle such as exercising for 30 minutes each day, stopping smoking, changing to a Mediterranean diet, getting seven hours of sleep each night, managing stress, and meeting with friends and family. You may need to go on medication for cholesterol, blood pressure or blood sugar. If your tests are very abnormal, an invasive angiogram to look at arteries might be done with a stent.

Most importantly, if there is any doubt, get checked out.

Have a question for the professionals you’d like answered? Get in touch with sarah.gill@image.ie with the subject headline ‘Ask The Doctor’.