Sneaky Symptoms of Heart Disease in Women That Are Often Overlooked (2025)

When it comes to signs of serious heart trouble, many of us imagine the Hollywood version—a man clutching his chest and collapsing. But for women, the symptoms of heart disease can be more subtle and are often mistaken for something else.

“Women tend to report symptoms that go beyond chest pain,” says Nieca Goldberg, MD, Clinical Associate Professor of Medicine at the NYU Grossman School of Medicine. “They might feel extreme shortness of breath, like they’ve run a marathon when they haven’t, or experience pressure in their upper back, neck or jaw.”

Understanding these differences can be life-saving. Cardiovascular disease is the leading cause of death for women in the United States. Here’s what you need to know to protect your heart health, plus key warning signs you need to visit a doctor.

What is heart disease?

The most common form of heart disease is coronary artery disease (CAD), which occurs when plaque builds up in the arteries and reduces blood flow to the heart. Complications of untreated CAD can include angina, heart failure, arrhythmia and a higher risk for a heart attack, which can be fatal.

Women’s risk factors for heart disease

These are several factors that can increase your odds of heart trouble. They include:

• High blood pressure
• High cholesterol
• Diabetes
• Smoking
• Obesity
• A family history of heart disease (if your father had a heart attack before age 50 or your mother before age 60, your risk may be higher)
• Having an autoimmune disease
• A history of preeclampsia or gestational hypertension

The typical age range when heart attacks strike differs between genders. “Women tend to experience heart attacks about 10 years later than men, often after menopause,” Dr. Goldberg explains. “But we’re now seeing more younger women—those in their 40s and even 30s—with heart disease, particularly if they have diabetes, a family history or high stress.”

Symptoms of heart disease in women

While chest pain or discomfort remains the most common sign of heart disease for both men and women, women are more likely to experience additional symptoms that are often overlooked, including:

• Extreme shortness of breath
• Nausea or vomiting
• Pain or pressure in the neck, jaw, back or upper abdomen
• Fatigue or weakness that feels sudden or unusual
• Cold sweats
• Heartburn or indigestion-like discomfort (less common but possible, especially when paired with other symptoms)

Heart disease is often called a “silent killer” because many of its early signs—like fatigue, shortness of breath or chest tightness—are easy to dismiss, especially for women. “Women often experience milder symptoms like fatigue or chest tightness during exertion weeks before a heart attack happens,” says Dr. Goldberg. “Recognizing those signs and coming in for testing can prevent something more serious.”

Lower chest pressure is another commonly-misinterpreted symptom. “Women often mistake it for a stomach problem,” Dr. Goldberg explains. “Some feel symptoms while resting or even sleeping, not just during physical exertion.” If symptoms occur at rest or waken you from sleep, they’re more worrisome and warrant and urgent visit to your doctor or a call to 911, she adds.

One key sign to watch for: If physical activities you used to do with ease, like walking a few blocks, now leave you feeling short of breath, Dr. Goldberg says it’s time to see a doctor.

When women should seek help for symptoms of heart disease

“If you’re noticing symptoms like chest tightness, shortness of breath or fatigue, start by seeing your primary care doctor,” says Dr. Goldberg. “They’ll take a detailed history and perform basic tests, such as checking your cholesterol, glucose levels and hemoglobin A1C to screen for diabetes.”

You may be referred to a cardiologist for more specialized testing. “Cardiologists can order a stress test to monitor how your heart responds to exercise,” says Dr. Goldberg.

Other tools include an echocardiogram, an ultrasound that evaluates the heart’s structure, blood flow and overall function. A newer diagnostic option is the CT calcium score test, which measures plaque buildup in the arteries. “It’s an important tool, especially for people with a family history or intermediate risk,” Dr. Goldberg says.

Note: If chest pain or shortness of breath occurs suddenly, call 911 immediately—they could be symptoms of a heart attack. “Don’t ignore them or wait to see if they’ll pass. Many women hesitate because they’re worried about their family or feel embarrassed if it turns out not to be a heart attack,” she adds. “But delaying care can be dangerous. The faster we can diagnose and treat a heart attack, the better the chance of saving heart muscle and preventing long-term damage.”

Listen to your heart and trust your instincts

“I always tell women to listen to their bodies,” Dr. Goldberg says. “We want women to recognize warning signs early and come in for testing,” she says.

Heart disease doesn’t have to be a silent killer. By recognizing the symptoms and seeking medical care when something feels off, you can take the first step toward keeping your heart healthy for years to come.

This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.