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Women’s heart attack symptoms are not all that different

Cardiovascular Disease in Women
Acute Coronary Syndromes

Sophia Antipolis – 4 May 2020:  The top three heart attack symptoms in both women and men are chest pain, sweating, and shortness of breath, reports a study presented today on EAPC Essentials 4 You, a scientific platform of the European Society of Cardiology (ESC), and published in the Journal of the American Heart Association.1

“Heart attack symptoms are often labelled as ‘typical’ in men and ‘atypical’ in women,” said study author Dr. Annemarijn de Boer of the University Medical Centre Utrecht, the Netherlands. “But our study shows that while symptoms can differ between the sexes, there are also many similarities.”

Whatever your gender, if you experience heart attack symptoms, don’t delay. Call the emergency services immediately.

Symptom recognition is crucial to enable fast, live saving treatment for people having a heart attack. Some previous studies report sex differences in symptoms while others report shared symptoms.

This study compiled the highest quality studies – 27 in total – from the past two decades detailing symptoms in patients with confirmed acute coronary syndrome (heart attack or unstable angina).

In addition to sharing the three most common symptoms, the majority of men and women experiencing an acute coronary syndrome had chest pain: 79% of men and 74% of women.

Significant differences in symptom presentation between women and men were also reported. Compared to men, women were more than twice as likely to have pain between the shoulder blades, 64% more likely to have nausea or vomiting, and 34% more likely to experience shortness of breath. Although chest pain and sweating were the most frequent symptoms in both women and men, they occurred less often in women, who had a 30% lower odds of chest pain and 26% lower odds of sweating compared to men.

The study did not investigate the reasons why there are some variations in symptom presentation between women and men, but Dr. de Boer said: “Previous research has shown sex differences in how heart attacks occur in the body, but it is uncertain how or whether this relates to symptom presentation. The cause of symptom differences between the sexes deserves further study.”



Notes to editor

Authors: ESC Press Office
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Funding: A. de Boer is supported by the ‘Facts and Figures’ grant from the Dutch Heart Foundation. S. Peters is supported by a UK Medical Research Council Skills Development Fellowship (MR/P014550/1).


Disclosures: None.


References and notes

1van Oosterhout REM, de Boer AR, Maas AHEM, et al. Sex Differences in Symptom Presentation in Acute Coronary Syndromes: A Systematic Review and Meta-analysis. J Am Heart Assoc. 2020;9:e014733. DOI:10.1161/JAHA.119.014733.


About the European Association of Preventive Cardiology

The European Association of Preventive Cardiology (EAPC) is a branch of the ESC. Its mission is to promote excellence in research, practice, education and policy in cardiovascular health, primary and secondary prevention.


About EAPC Essentials 4 You    #EAPCessentials4U

EAPC Essentials 4 You is a platform for scientific content related to preventive cardiology. New content will be added regularly.


About the European Society of Cardiology

The European Society of Cardiology brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people lead longer, healthier lives.