How heart attack symptoms in women differ from men and why it matters

Business Standard

03-07-2025

Heart conditions among Indian women are on the rise—and at an alarming rate. Research published in the Journal of the American College of Cardiology shows that the prevalence of coronary artery disease in Indian women ranges from 3 per cent to 13 per cent, depending on age. Even more concerning, this number has increased by nearly 300 per cent over the past two decades.
The mean age for a heart attack in Indian women is 59 years, significantly lower than the average in developed countries. Meanwhile, the prevalence of heart failure has more than doubled, rising from 1.1 per cent in 2000 to 2.6 per cent in 2015.
These figures make it clear: India needs greater awareness, early screening, and a gender-specific approach to heart health.
How do heart attack symptoms in women differ from those in men?
Heart attack symptoms in women are often subtle and differ from the classic signs seen in men. While men usually report severe chest pain, women are more likely to experience discomfort in the back, jaw, or stomach, along with breathlessness, unusual fatigue, nausea, or dizziness. These symptoms can be mistaken for acidity, weakness, or anxiety, especially in Indian settings where women tend to ignore their health issues. This difference in symptom presentation often leads to late diagnosis and delayed treatment, particularly in younger or post-menopausal women who may not be perceived to be at high cardiac risk.
Why are heart attacks in women often misdiagnosed or missed?
Heart attacks in women are often overlooked because their symptoms tend to differ from the typical patterns seen in men. Many women delay seeking medical help, attributing signs like breathlessness, indigestion, or fatigue to daily stress or household responsibilities. For example, a woman in her forties may present with persistent fatigue and a burning sensation in the chest or upper abdomen, which may be mistaken for acidity. Similarly, a homemaker experiencing jaw pain or dizziness might dismiss it as exhaustion. These situations are increasingly common in urban and semi-urban India, where a lack of awareness about female-specific cardiac symptoms leads to delayed treatment.
What are the unique risk factors and warning signs for women?
Yes, there are several risk factors unique to women that must not be ignored. Hormonal changes due to early menopause, pregnancy-related conditions like high blood pressure or gestational diabetes, and conditions like PCOS increase the likelihood of future heart problems. Mental health issues and chronic stress, especially in urban women juggling work and family, also raise the risk.
Warning signs like sudden tiredness, shortness of breath on routine tasks, chest discomfort, or disturbed sleep should not be taken lightly. Women must be proactive, especially if there's a family history of heart disease or lifestyle-related disorders.
What preventive steps should women take across life stages?
Heart health must be prioritised from an early age. In their twenties and thirties, women should maintain a balanced diet, regular physical activity, and avoid smoking and excessive sugar or salt. In their forties and fifties, routine health check-ups for blood pressure, blood sugar, and cholesterol become crucial, particularly around menopause. Beyond sixty, managing existing conditions like diabetes or thyroid issues is essential, along with staying mentally and physically active.
Which tests help detect heart risks early in women?
To truly assess heart health—especially for women who may have subtle or 'silent' symptoms—more detailed testing is often required:
Echocardiogram (ECHO): Non-invasive ultrasound that checks heart structure and function (₹2,000–₹3,500)
Treadmill Test (TMT): Evaluates how the heart responds to stress or exercise (₹1,500–₹3,000)
Apolipoproteins A and B: Advanced cholesterol markers that offer deeper insights (₹1,000–₹1,800)
Plaque Imaging (Coronary Calcium Scoring/CT Angiography): Detects plaques in arteries before they block (₹4,000–₹10,000)
By combining these tests, doctors can offer a more comprehensive and personalised view of cardiovascular health.
What treatment gaps still exist for women?
Dr Nilesh Gautam, cardiologist at Lilavati Hospital, Mumbai told Business Standard:
'Women often respond differently to heart attack treatments than men, and this significantly affects outcomes. Men typically reach hospitals faster, report classic symptoms like chest pain, and are more likely to receive timely interventions such as angioplasty or clot-dissolving medication. Women, on the other hand, frequently experience subtler symptoms, which leads to delayed hospital visits and often missed diagnoses.'
'Even when treated, women are more likely to experience complications from procedures and side effects from standard cardiac medications like statins or blood thinners. These differences, supported by multiple Indian and global studies, translate into slower recovery, higher post-treatment risk, and poorer long-term outcomes in women. Recognising these distinctions is key to delivering gender-sensitive care in India,' he added.
What is the way forward for women's heart health?
Despite the rising numbers, heart health in women remains under-researched and under-reported. Public awareness campaigns, routine check-ups, and proactive prevention strategies are the need of the hour.
As Dr Gautam suggests, women must be empowered to recognise symptoms early and seek timely care. Heart disease may not discriminate, but our response to it must be more inclusive.