What chest pain means for women: Recognizing symptoms and getting the right care

Chest pain in women can present differently and should be evaluated quickly.

Chest pain is the second most common cause for emergency room visits in the U.S., with nearly 11 million visits by adults annually. While chest pain is a key sign of a heart attack, it can also be caused by other conditions, such as gastroesophageal reflux disease (GERD) or heartburn.

Chest pain in women may differ from that in men, which can cause delays in care and affect outcomes. Recognizing these differences is crucial for prompt diagnosis and treatment.

What is chest pain?

Chest pain, also known as angina, is a discomfort or pain in any part of the chest, specifically the area between the neck and stomach. Chest pain can be "sharp," meaning sudden and severe, or "dull," which can feel more like a deep ache or pressure.

In some cases, the pain may spread to other parts of your body, including your arms, neck or jaw. It can last anywhere from a few minutes to several hours. Chest pain that lasts for more than a few weeks is considered chronic.

Chest pain isn't a disease itself but a symptom of an underlying problem. Although it's commonly linked to issues such as coronary artery disease — a blockage of arteries that supply blood to the heart — some conditions that cause chest pain don't involve the heart at all.

Common non-heart-related conditions that can cause chest pain include:

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• Asthma
• Anxiety or panic attacks
• GERD
• Indigestion
• Pneumonia

How does chest pain manifest?

Most people picture a heart attack as a man suddenly clutching his chest in pain. But for women, heart attack symptoms are often more subtle and might be mistaken for something less serious. Instead of the classic "elephant sitting on my chest" feeling, women may experience pressure, tightness or an uncomfortable squeezing sensation. Chest pain is described using various terms, depending on how you perceive your pain. People frequently report chest pain, pressure, tightness, heaviness, soreness, discomfort, pressing or crushing in the chest.

Other symptoms of chest pain may include:

• Abdominal pain
• Discomfort or pain in one or both arms
• Excessive sweating
• Fatigue
• Nausea or vomiting
• Pain in the back, jaw or teeth
• Shortness of breath
• Stabbing pain instead of chest pressure

Risk factors for chest pain

Risk factors for coronary artery disease include:

• Family history of early onset heart disease
• High blood pressure
• High cholesterol
• Lack of physical activity
• Obesity
• Smoking

Women may have additional risk factors including:

• Autoimmune conditions, such as lupus or rheumatoid arthritis
• Emotional stress or depression
• Hormonal changes
• Pregnancy complications such as pre-eclampsia and/or eclampsia

How is chest pain diagnosed?

If you experience chest pain lasting longer than five minutes or that doesn't go away after taking medication, call your doctor or go to the emergency room right away. While chest pain doesn't always indicate a heart attack, it's crucial to get checked quickly in case treatment is needed.

When you arrive at the hospital, the doctor will review your symptoms and check your blood pressure and heart rate. They might order one of several tests, such as:

• Blood test: This can detect enzymes released by damaged heart muscle cells.
• Chest X-ray: A chest X-ray shows the condition of the heart and lungs. It can help rule out other causes of chest pain.
• Computerized tomography (CT) scan: This scan uses X-rays to take cross-sectional images of the heart to detect blood flow issues.
• Electrocardiogram (ECG or EKG): This test records the heart's electrical signals and detects any abnormalities in heart rhythm or damage to the heart.

How to prevent chest pain

Some causes of chest pain are preventable, but not all. Still, you can manage most heart problems with lifestyle changes, including:

• Eating a balanced diet rich in fruits, vegetables and whole grains
• Exercising for at least 150 minutes per week at moderate intensity, such as brisk walking or cycling
• Getting enough sleep
• Limiting alcohol intake
• Losing weight
• Managing existing health conditions like high blood pressure or high cholesterol
• Quitting smoking
• Reducing stress

Getting regular checkups and screenings is also important, especially if you have a family history of heart disease or heart attack.

Chest pain should never be ignored, even if the symptoms seem mild. If it turns out to be a heart attack, acting quickly can save a life. Understanding how chest pain manifests, along with potential risk factors, can help prevent complications and improve outcomes. Call your doctor if you're unsure why you're experiencing chest pain; your answers can help determine whether you need to be evaluated at the hospital.