November 11, 2026, 5:55 am | Read time: 6 minutes
Women generally experience heart attacks less frequently and later than men. The problem: Heart attacks can be harder to detect in women. Instead of the typical severe chest pain, symptoms like back pain, nausea, or unusual fatigue may occur. As a result, heart attacks in women are sometimes recognized and treated too late, which can worsen their chances of survival.
Although men suffer heart attacks (myocardial infarctions) more frequently and at a younger age, women are more likely to die from them. Why is that? One possible reason is that many only associate a heart attack with severe, crushing chest pain–a typical symptom for men. Women may exhibit subtler signs of a heart attack, which many are unaware of.1,2 For women, jaw, back, neck pain, or fatigue can indicate a heart attack.
Typical Signs of a Heart Attack in Women
- Pain in jaw, back, neck
- Pain between shoulder blades
- Fatigue and dizziness
- Shortness of breath with mild exertion
- Nausea and vomiting
- Pale skin
- Upper abdominal pain
- Pain in chest and arm
- Cold sweat
- Feelings of tightness and anxiety
Typical Signs of a Heart Attack in Men
- Shortness of breath
- Pain in back, shoulders, and lower jaw
- Dizziness and unconsciousness
- Pain radiating to the left arm
- Nausea and vomiting
- Pale skin
- Upper abdominal pain
- Sharp pain in the left chest area and behind the breastbone
- Cold sweat
- Feelings of tightness and anxiety
Also interesting: Cardiac arrest, heart attack, and acute heart failure–how to recognize the difference
Chest Pain in Men Particularly Pronounced
Heart attacks are traditionally classified based on EKG changes, which show how heart excitation spreads and recedes. In the so-called STEMI (ST-elevation myocardial infarction), an acute vessel blockage leads to severe tissue damage in the heart muscle, visible in the EKG as a typical ST-segment elevation. This type of heart attack occurs more often in men than in women and tends to affect younger people. Chest pain is particularly pronounced in patients with acute STEMI.3
Besides STEMI, there is NSTEMI (non-ST-elevation myocardial infarction), where the described elevation is absent. Clinically, an increase in troponin T levels in the blood is diagnosed.
What Happens During a Heart Attack in the Body
The heart is supplied with oxygen through many small blood vessels. Over time, deposits can form in these vessels. If such a deposit ruptures, a blood clot can form, blocking the vessel. Then, little or no blood reaches part of the heart muscle, which doesn’t get enough oxygen and begins to die. This is called a heart attack.
The most common cause of death in Germany is a circulatory system disease. With nearly 350,000 deaths in 2023, cardiovascular diseases–especially heart attacks and ischemic heart diseases–accounted for more than a third of the approximately one million deaths that year.4 No day of the year sees as many heart attacks as Christmas Eve. The late evening hours around 10 p.m. are particularly risky, when strong emotions, stress, and excitement further strain the heart.5
What Determines the Severity of a Heart Attack
The severity of a heart attack depends on the affected vessel and its location. The larger the affected vessel, the more severe the damage to the heart muscle.
In very mild cases, days or weeks may pass before individuals see a doctor and suddenly learn of the heart attack diagnosis. Such cases are rare, and it’s fortunate if they are recognized in time before something worse happens.
Possible Consequences of a Heart Attack
Such a circulatory disorder can lead to arrhythmias, in the worst case to ventricular fibrillation and sudden cardiac death. Unfortunately, sudden cardiac death from a heart attack can be the first symptom of coronary artery disease (arteriosclerosis).
Also interesting: How to Prevent a (Second) Heart Attack
Who Has an Increased Risk of Heart Attack
Smoking, obesity, and high cholesterol levels, diabetes mellitus, and high blood pressure increase the risk of a heart attack. Too much stress can also be a potential trigger.
Age and gender are also important factors: The likelihood of a heart attack increases with age.
It’s important to understand that coronary artery disease is not an age-related illness but can manifest earlier. In 50 percent of cases, affected men experience the event before age 60.
The risk factors for a heart attack at a glance:
- High blood fats
- Diabetes mellitus (Type 2 diabetes)
- Smoking
- High blood pressure
The Outlook with Timely Treatment
With timely treatment, the chances of successful recovery are good, and depending on the severity of the heart attack, the patient may recover without severe long-term damage. However, heart attack patients must be monitored and treated for life. The earlier the heart attack is detected and treated, the better the prognosis.6,7,8
Cardiologist Dr. Christopher Schneeweis offers tips for a strong heart
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What to Do If You Suspect a Heart Attack
If you experience symptoms and signs indicating a heart attack, call emergency services at 112. In the hospital, the affected artery in the heart can usually be reopened, allowing blood to flow again. Every minute counts to minimize heart muscle damage and reduce the risk of long-term effects like heart failure.
A Tablet of Aspirin
While waiting for the ambulance, taking 100 milligrams of acetylsalicylic acid–found in a tablet of aspirin–is generally advisable, as it positively affects blood platelets.
Otherwise, stay calm and try to contact someone so you’re not alone. The greatest immediate danger of a heart attack is the occurrence of malignant arrhythmias, which can lead to cardiac arrest within minutes. It’s crucial to have someone who can perform chest compressions and open the door for emergency responders.
How to Prevent a Heart Attack
Don’t smoke. Studies show that quitting smoking after smoking a pack a day for 20 years or two packs a day for 10 years reduces the heart attack risk by 40 percent five years later (the stroke risk also decreases by this percentage). For alcohol, recent scientific findings indicate no safe dose.
A Mediterranean diet rich in vegetables, fruits, whole grains, legumes, olive oil, nuts, and fish has been proven to reduce the risk of cardiovascular diseases. Reduce red meat, highly processed products, sugar, and trans fats (not just for heart health). Finally, exercise: For people with a healthy heart, at least 150 minutes of endurance plus two strength sessions per week are ideal.
It’s also advisable for everyone to determine their risk profile early to identify: Do I have a predisposition for high cholesterol levels? Is my lipoprotein(a) level elevated? Are there early heart attack events in my family? Do I have elevated long-term blood sugar (HbA1c) indicating diabetes mellitus? Blood pressure should also be measured occasionally to detect the risk factor of high blood pressure as early as possible.
Early intervention can potentially prevent heart attacks and other events. Learn more about perfect heart attack and stroke prevention here.