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Heart Attacks In Young Women Don't Always Cause Chest Pain

When you think of the signature symptom of a heart attack, chest pain probably comes to mind. But according to a new study, when some young and middle-aged women have a heart attack, they won't experience this tell-tale sign.

"We need to move away from the image of an older man clutching his chest, when we think about acute coronary syndrome," which includes heart attacks and angina, study researcher Dr. Louise Pilote, director of the Division of General Internal Medicine at McGill University Health Centre, said in a statement. "The reality is that chest pain, age and gender are no longer the definers of a heart attack."

The new study, published in the journal JAMA Internal Medicine, is based on data from 1,000 young patients hospitalized for acute coronary syndrome. Even though chest pain was the most common symptom of heart attack in both sexes, researchers found that one in five women age 55 and younger didn't experience chest pain with their heart attack. Plus, women in general were less likely to experience chest pain from heart attack than men.

The researchers also didn't find an association between not experiencing chest pain and having a less severe heart attack.

"Our study demonstrates that young people and women who come into the emergency without chest pain, but other telltale ACS symptoms such as weakness, shortness of breath and/or rapid heartbeats, are in crisis," Pilote said in the statement. "We need to be able to recognize this and adapt to new standard assessments in previously unrecognized groups such as young women."

For women in particular, signs of a heart attack include feeling pain in the arms, back, stomach or neck; feeling shortness of breath; feeling lightheaded or nauseous; and having a pressure or squeezing feeling in the chest, according to the American

 

These symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks. This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart -- a condition called small vessel heart disease or microvascular disease.