Dear Ms.
Studies have shown that women's symptoms are not usually identified as being related to heart disease.

Symptoms of coronary artery disease
Women develop symptoms of heart disease an average of 10 years later than men.

Women report symptoms prior to having a cardiac event, although these are not typical “heart” symptoms. In a multi-center study of 515 women who had an acute heart attack (MI), the most frequently reported symptoms were unusual fatigue, sleep disturbances, shortness of breath, indigestion and anxiety. The majority of women (78 percent) reported at least one symptom for more than one month before their heart attack. Only 30 percent reported chest discomfort, which was described as an aching, tightness, pressure, sharpness, burning, fullness or tingling 1.

If you have these symptoms, you should contact your doctor for a full evaluation. This is even more important if you have risk factors for heart disease, such as family history, smoking, diabetes, hypertension, and hyperlipidemia. A full risk factor evaluation, combined with symptoms and an exam, will help the doctor know your risk for future events and guide additional testing.

Symptoms of a Heart Attack
Women are less likely to recognize the symptoms of a heart attack and seek treatment right away. For more information on heart attack in women, click here

Women tend to have heart attacks about 10 years later than men do 1.

By learning and recognizing the symptoms, women can become more assertive in their treatment.

The most common symptoms of heart attack in women are 2:

•Shortness of breath
•Weakness
•Unusual fatigue
•Cold sweat
•Dizziness
•Pain or pressure in the back or high chest
•Pain or discomfort in one or both arms
•Discomfort may be described as pressure, ache, or tightness; may come and go
•A burning sensation in the chest or upper abdomen
•Irregular heartbeat
•Nausea
If you have angina
If you have angina that lasts more than 5 minutes - and you DO NOT have a prescription for nitroglycerin - call for emergency help. DO NOT DELAY. Call for emergency help (dial 911 in most areas). Quick treatment of a heart attack is very important to lessen the amount of damage to your heart. Due to the possible benefits of taking aspirin early on during a heart attack, emergency personnel may tell you to chew an aspirin if there is no medical reason for you to avoid aspirin. If your symptoms stop completely in five minutes, still call your doctor to report your symptoms.

If angina occurs and you have been prescribed nitroglycerin (a medication):

•Stop what you are doing and rest.
•Take one nitroglycerin tablet and let it dissolve under your tongue, or if using the spray form, spray it under your tongue. Wait 5 minutes.
•If you still have angina after 5 minutes, call for emergency help (dial 911 in most areas) or have someone take you to the local emergency room. Emergency personnel may tell you to chew an aspirin to break up a possible blood clot, if there is not a medical reason for you not to take aspirin.
1.Quick Facts About Heart Disease and Stroke, American Heart Association.
2.McSweeney, J., Cody, M., O’Sullivan, P., Elberson, K, Moser, D., Garvin, B. Women’s Early Warning Symptoms of Acute Myocardial Infarction. Circulation. 2003; 108:2619-2623.
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I hope this reference is helpful.
Gerry Lane