Cardiovascular disease remains one of the most common causes of death among women in Switzerland and Europe. Men more often report pronounced chest pain; women often describe less typical symptoms.

Heart attack: typical chest pain

  • Pressure or tightness in the chest
  • Pain radiating to the arms, shoulders, back, neck or jaw
  • Jaw pain
  • Cold sweats

Heart attack: atypical symptoms

  • Shortness of breath
  • Upper abdominal discomfort
  • Nausea or vomiting
  • Unusual exhaustion and reduced performance
  • Palpitations and dizziness

When should you call the emergency number 144?

If a heart attack is suspected, do not wait. The sooner a blocked coronary artery is reopened, the better the chance of avoiding permanent heart damage. If in doubt, call 144 (the Swiss ambulance number) early. Better once too often than once too rarely.

Why heart attacks in women are often recognised later

Studies show that women often seek medical help later than men. Their symptoms are also often first put down to stress, exhaustion, the menopause or stomach problems.

Particular risk factors in women

The classic risk factors apply to women too:

There are also risk factors specific to women:

  • Gestational diabetes
  • Pre-eclampsia (pregnancy hypertension)
  • Early menopause
  • Autoimmune diseases

Heart attack despite unremarkable coronary arteries

Women more often develop particular forms of heart attack such as MINOCA, coronary microvascular dysfunction, spontaneous coronary artery dissection (SCAD) or takotsubo cardiomyopathy. A specialised cardiological work-up is therefore often needed.

Which examinations may be useful?

In an acute heart attack, immediate cardiac catheterisation to reopen the blocked coronary artery is usually required.

Without an acute heart attack, several examinations may be used depending on symptoms, risk factors and the clinical question:

  • Resting ECG to detect arrhythmias or signs of impaired blood flow
  • Echocardiography (heart ultrasound) to assess heart function, valves and wall motion
  • Stress testing to detect exertion-related blood flow problems, for example stress echocardiography, myocardial PET or stress MRI
  • Coronary CT for non-invasive imaging of the coronary arteries and to rule out significant narrowings
  • Cardiac MRI to investigate heart muscle disease, myocarditis or particular forms of heart attack
  • Cardiac catheterisation for direct imaging of the coronary arteries and, if needed, immediate treatment with balloon dilatation and stent implantation

Summary

Heart attacks in women are still underestimated far too often. As the symptoms often differ from men's, warning signs should be taken seriously and investigated early. Modern cardiological diagnostics can now identify risk factors and heart disease early, often before a heart attack occurs.