Heart Attack Symptoms in Men and Women: Signs to Know

Think it’s a heart attack? Call now 082 911 Emergencies, 24 hours a day

Key takeaways
•Chest pain or pressure is the most common symptom for both men and women.
•Women are more likely to have breathlessness, nausea, unusual tiredness, or back or jaw pain, sometimes without chest pain.
•Call 082 911 at once, and don’t drive yourself to hospital.
•Only give aspirin if the call taker or a doctor tells you to.
•If the person collapses and stops breathing normally, start CPR straight away.

Heart disease is one of South Africa’s biggest killers. According to the Heart and Stroke Foundation South Africa, about 225 South Africans die of heart disease or stroke every day. Many of those deaths happen because help arrived too late.

Most of us picture a heart attack as a sudden collapse, like in the movies. In reality, many heart attacks start slowly, with mild discomfort that comes and goes. People often put it down to indigestion or stress and wait for it to pass, and women are especially likely to do this. In this guide, we’ll cover the common and the subtle signs in men and women, and exactly what to do in the first few minutes.

What is a heart attack?

A heart attack happens when blood flow to part of the heart muscle is blocked. This is usually caused by a blood clot forming on a fatty build-up, called plaque, inside the arteries that feed the heart. Without blood, that part of the heart muscle starts to die.

The longer the blockage lasts, the more damage it causes, which is why fast treatment matters so much. Doctors call a heart attack a myocardial infarction, and the narrowing of the arteries behind it is known as coronary artery disease.

Common heart attack symptoms

Heart attack symptoms vary from person to person. These are the most common signs to look out for:

•Chest discomfort: pressure, squeezing, fullness, tightness or pain in the centre or left side of the chest. It usually lasts more than a few minutes, or goes away and comes back.

•Pain that spreads: to one or both arms, the back, shoulders, neck, jaw or upper stomach.

•Shortness of breath, with or without chest discomfort.

•A cold sweat that comes on suddenly.

•Nausea or vomiting, or discomfort that feels like indigestion or heartburn.

•Light-headedness or dizziness.

•Unusual tiredness that you can’t explain.

•An overwhelming sense of anxiety, as if something is badly wrong.

You may have only one of these symptoms, or several at once. Other conditions affecting the stomach, lungs or chest wall can also cause chest pain, and only tests can tell the difference. As the Heart and Stroke Foundation South Africa puts it: if in doubt, get checked out.

Heart attack symptoms in men vs women

Chest pain or discomfort is the most common heart attack symptom for both men and women (American Heart Association). But women are more likely to have other symptoms alongside it, or instead of it. Here’s how they tend to compare:

Symptom	Men	Women
Chest pain or pressure	Most common, often described as crushing or heavy	Still most common, but may be milder or absent
Pain in the arm, back, neck or jaw	Often in the left arm	More often in the back, shoulders or jaw
Shortness of breath	Common	More likely, and sometimes the main symptom
Nausea or vomiting	Less common	More likely
Unusual tiredness	Less common	More likely, sometimes for days beforehand
Anxiety	Possible	More likely

These are patterns, not rules. Anyone can have any of these symptoms, so take every sign seriously.

Why women often wait longer for help

Because women’s symptoms can feel like flu, indigestion or stress, they are easy to brush off. Many women also think of heart disease as a men’s problem, so a heart attack isn’t the first thing that comes to mind. The result is that women often get treatment later. Heart disease affects women too, so if something feels wrong, trust your instincts and call for help.

Heart attack risks particular to women

Some factors raise heart attack risk for women in particular (Mayo Clinic):

•Going through menopause

•A history of preeclampsia (high blood pressure during pregnancy)

•Autoimmune conditions such as rheumatoid arthritis and lupus

For more on women’s health, see our guides to the most common women’s health problems, the early signs of rheumatoid arthritis and health insurance for women.

Early warning signs: the days and weeks before

A heart attack doesn’t always come out of nowhere. Your body may give you warnings, such as:

•Chest pain or pressure that comes on when you’re active and eases when you rest. This is called angina.

•Chest pain that keeps coming back, or doesn’t go away with rest. This may be an early warning of a heart attack.

•Unusual tiredness, or getting out of breath doing things that used to be easy.

If you notice any of these, see a Network GP soon or speak to a doctor through Hello Doctor. If the pain comes on while you’re resting, or lasts more than a few minutes, treat it as an emergency and call 082 911. You can also read about what happens if you need to see a cardiologist.

Silent heart attacks

Some heart attacks cause mild symptoms or none at all. These are known as silent heart attacks, and they are often only found later on a heart tracing (ECG).

They are more likely in older adults and people with diabetes, whose symptoms may seem unrelated to the heart, such as brief neck or back pain, or nausea. A silent heart attack still damages the heart, so regular check-ups really matter. Learn more in our guide to diabetes and diabetes and health insurance.

What to do if someone is having a heart attack

Acting quickly and calmly can save a life. Here’s what to do, step by step:

1	Call for an ambulance straight awayPhone 082 911. Don’t wait to see if the symptoms pass, and don’t drive the person to hospital yourself. Paramedics can start treatment as soon as they arrive.
2	Help them restSit them on the floor with their knees bent and their head and shoulders supported, for example against a wall or sofa. Loosen any tight clothing (St John Ambulance).
3	Ask the call taker about aspirinChewing an aspirin can help limit damage to the heart, but only give it if the call taker or a doctor advises it. Never give aspirin to someone who is allergic to it, a child under 16, or anyone showing signs of a stroke. Don’t delay calling for help to look for aspirin.
4	Help with their own medicineIf they have prescribed angina medication, such as a spray used under the tongue, help them take it as their doctor prescribed.
5	Stay with themKeep them calm and still, and watch their breathing until help arrives.
6	Start CPR if they collapseIf they become unresponsive and aren’t breathing normally, start CPR. Push hard and fast in the centre of the chest, about 100 to 120 times a minute. Use a defibrillator (AED) if there is one nearby. The call taker will guide you.
7	Gather important informationFind a list of their medicines and medical conditions, their ID and their medical aid or health insurance card. Health4Me members have a digital membership card on the Momentum App.
8	Get authorisation once help is on the wayHealth4Me emergency cover needs pre-authorisation. Once the ambulance is on its way, the member or a family member should call 0860 10 29 03 for authorisation.

If you think you’re having a heart attack yourself

Call 082 911 immediately, even if you’re not sure. Stop what you’re doing and sit down. Unlock your front door if you can, don’t try to drive, and tell anyone nearby what’s happening so they can help.

Heart attack, cardiac arrest or stroke?

These three emergencies are often confused, but they need slightly different first aid. Here’s how to tell them apart:

Emergency	Key signs	First action
Heart attackBlood flow to part of the heart is blocked	Chest pain or pressure, breathlessness, sweating. The person is usually awake.	Call 082 911. Aspirin only if advised.
Cardiac arrestThe heart suddenly stops pumping	Collapse, no response, not breathing normally	Call 082 911, start CPR and use a defibrillator.
StrokeBlood flow to part of the brain is cut off, or a blood vessel bursts	Balance, eye, face, arm or speech changes	Call 082 911. No aspirin, food or drink.

A heart attack can lead to cardiac arrest, which is why it’s important to watch the person’s breathing closely. To learn the warning signs of a stroke, read our guide to the signs of a stroke.

Who is at risk of a heart attack?

Anyone can have a heart attack, but some things make it more likely.

Risks you can manage	Risks you can’t change
•High blood pressure•High cholesterol•Diabetes•Smoking and second-hand smoke•Carrying extra weight•Not being active•A diet high in salt, sugar and processed food•Ongoing stress•Drug use, such as cocaine or amphetamines	•Getting older•A family history of early heart attacks•A history of preeclampsia•Autoimmune conditions such as rheumatoid arthritis or lupus

Many of these risks have no symptoms, so regular checks are the best way to catch them early. Start with our tips to lower blood pressure naturally, learn how to monitor your blood pressure at home, and read about medications that cause high blood pressure, the effects of smoking and the stages of heart failure.

How Health4Me helps your heart

Health4Me’s accident and emergency cover includes heart attacks and strokes that need immediate medical treatment and meet the qualifying criteria, at a private hospital. Here’s how Health4Me supports you in an emergency, after a heart attack and before anything happens.

In an emergency

Subject to clinical approval and the per-event limits, emergency cover for a heart attack includes:

•Emergency transport, stabilisation and treatment

•A casualty benefit and an in-hospital benefit for each event

•Diagnostic scans such as CT and MRI scans

•Take-home medication

•Prosthetics and assistive devices

•Rehabilitation services such as wound care, physiotherapy and occupational therapy

After a heart attack

•Chronic cover for 27 conditions, including coronary artery disease, cardiac failure, cardiomyopathy and cardiac dysrhythmias, as well as hypertension, hyperlipidaemia (high cholesterol) and diabetes. Pre-authorisation and waiting periods apply.

•Specialist visits: up to two visits a year to a specialist such as a cardiologist, with a Network GP referral and pre-authorisation. Any shortfall is paid by the member, and waiting periods apply.

•Emotional support: it’s normal to feel anxious or low after a heart attack. Health4Me members have free access to the Employee Assistance Programme for telephonic counselling and support.

Before: keeping your heart healthy

•A yearly health assessment that checks your blood pressure, cholesterol and blood sugar, plus your height, weight and waist, at a Wellness Day or a pharmacy clinic such as Dis-Chem, Clicks or MediRite.

•Your Healthy Heart Score from that assessment can earn you monthly More4Me rewards, such as airtime, data or shopping vouchers.

•Multiply Engage gives you free access to a digital health and fitness assessment on the Momentum App, with rewards from a wide range of partners.

•Unlimited GP visits at a Network GP, and unlimited Hello Doctor consultations by chat, phone or video call, 24 hours a day.

You can see what’s included on our benefits page or learn more about Health4Me health insurance.

Look after your heart, and your budget Health4Me combines emergency cover for qualifying heart attacks and strokes with a yearly health assessment, unlimited GP visits and Hello Doctor consultations. Find the option that suits your needs and budget. Compare optionsGet a call back

Frequently asked questions

What are the first signs of a heart attack?

The first sign is usually chest pain or pressure that lasts more than a few minutes, or goes away and comes back. It often comes with shortness of breath, a cold sweat or nausea. If you notice these signs, call 082 911 straight away.

How do heart attack symptoms differ in women?

Chest pain is still the most common symptom for women. But women are more likely than men to have shortness of breath, nausea, unusual tiredness, or pain in the back, shoulders or jaw, sometimes without obvious chest pain.

Can you have a heart attack without chest pain?

Yes. Some people, especially women, older adults and people with diabetes, have a heart attack without chest pain. They may only feel breathless, sick, dizzy or very tired. If in doubt, get checked out.

What is a silent heart attack?

A silent heart attack causes mild symptoms or none at all, so it can go unnoticed. It is often found later on a heart tracing (ECG). Even without symptoms, it still damages the heart, which is why regular check-ups matter.

How long does a heart attack last?

Heart attack symptoms usually last more than a few minutes and may come and go. Don’t wait to see if they pass. Every minute the blockage continues, more heart muscle is damaged, so call 082 911 straight away.

Should I take aspirin during a heart attack?

Only if the call taker or a doctor tells you to. Never take aspirin if you are allergic to it or if you might be having a stroke. Always call 082 911 first rather than searching for aspirin.

What is the difference between a heart attack and cardiac arrest?

A heart attack happens when blood flow to part of the heart is blocked, and the person is usually awake. Cardiac arrest happens when the heart suddenly stops pumping, and the person collapses. A heart attack can lead to cardiac arrest.

Can anxiety feel like a heart attack?

Yes. A panic attack can cause chest tightness, a racing heart and shortness of breath. You can’t reliably tell the two apart at home, so always treat chest pain as an emergency and let a doctor rule out a heart attack.

Does health insurance cover a heart attack?

Health4Me’s accident and emergency cover pays for qualifying heart attacks at a private hospital, including emergency transport, casualty and in-hospital treatment, up to per-event limits. It is available on the Base and Standard options, and pre-authorisation is required.

Final thoughts

Knowing the signs of a heart attack, including the subtle ones, could help you save a life. Share this guide with your family, especially the women in your life, and save 082 911 in your phone. Don’t wait it out: if something feels wrong, call for help. If you’d like to know more about emergency cover, compare our options or ask for a call back and our team will gladly help.

Disclaimer: This article is for general information only and does not replace medical advice. If you think someone is having a heart attack, call 082 911 immediately.

Momentum Health4Me is not a medical scheme product and is not a substitute for medical scheme membership. Benefits are subject to the product terms and conditions, including pre-authorisation, waiting periods and benefit limits.