The Silent Symptoms 71 Percent of Women Have a Month Before a Heart Attack

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You may think all heart attacks come with chest pain or discomfort in your left arm, but over the years, research has shown that what Hollywood shows you when it comes to a heart attack may not be close to reality. Studies have found that not only are these symptoms not hallmarks for all patients, but women experience different heart attack symptoms than men. And in many cases, red flags can crop up weeks before the actual cardiac event, if you know what to look for. Landmark research from the American Heart Association (AHA) on heart attacks among women found that 95 percent of them develop new symptoms a month prior to the event that go away after their heart attack, and 71 percent share the same subtle symptom. Read on to find out what it is.

Seventy-one percent of women report feeling unexplained fatigue in the weeks before their heart attack.

In 2003, the AHA conducted a survey of more than 500 women who survived heart attacks, the results of which were published in the journal Circulation. Among the 95 percent of participants who said they noticed something wasn’t right in the month or so before their heart attacks, the most common was unexplained fatigue. According to the research, 71 percent of women reported feeling tired for no logical reason in the weeks before their heart attack.

In an article for the Cleveland Clinic, cardiologist Leslie Cho, MD, explains that if your fatigue is new or dramatic, you should consider the possibility of a heart attack. According to Cho, if you are exhausted after your typical workout, if you feel tired while resting, or if something as simple as making the bed wipes you out, you should talk to your doctor.

Half of women also experience sleeplessness prior to a heart attack.

It’s not just unexplained fatigue that could signal a heart attack. If you can’t sleep, that’s another cause for concern. According to the AHA survey, almost half—48 percent—of women who survived a heart attack said they experienced sleep disturbance up to a month before the event.

That’s why Cho said if you feel exceptionally tired, but you also experience sleep disturbance, that could be an early indicator of a heart attack.

Less than 1 in 3 women experienced chest pain at the onset of their heart attack.

The survey also found that only 31 percent of women experienced what’s considered the tell-tale heart attack symptom: pain centered high in chest. On top of that, 43 percent reported no chest pain during their heart attacks at all.

“Lack of significant chest pain may be a major reason why women have more unrecognized heart attacks than men or are mistakenly diagnosed and discharged from emergency departments,” researcher Jean C. McSweeney, PhD, RN, a professor at the University of Arkansas for Medical Sciences, said in a statement at the time. “Many clinicians still consider chest pain as the primary symptom of a heart attack.”

The most common symptom among women having a heart attack is shortness of breath.

While unexplained fatigue is the most common early sign of a heart attack, according to the AHA research, women are more likely to report experiencing shortness of breath than any other symptom once their heart attack begins. Fifty-eight percent of respondents experienced the symptom during their heart attack, while 42 felt it in the weeks leading up to the cardiac event.

That’s why the AHA says that if you’re experiencing shortness of breath, with or without chest pain, you should call 911 and head to a hospital ASAP.

Nieca Goldberg, MD, medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center, told the AHA that women tend to chalk up their heart attack symptoms to less life-threatening conditions like acid reflux or the flu. “There are still many women who are shocked that they could be having a heart attack,” Goldberg said.

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