Is Sex Dangerous If You Have Heart Disease?

Special Heart Risks for Men

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

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Men develop heart disease 10 years earlier, on average, than women do. They also have an early warning sign that few can miss: erectile dysfunction (ED). “It’s the canary in the coal mine,” says a Johns Hopkins expert. “Sexual problems often foretell heart problems.”

On the plus side, any risk factor—even ED—that gets your attention can put you on a path to better preventive care.

Heart Risk Factor: Erectile Dysfunction

“A lot of people think erectile dysfunction is the inability to get an erection at all, but an early sign of the condition is not being able to maintain an erection long enough to have satisfactory sexual intercourse,” says a Johns Hopkins expert. Erectile problems aren’t a normal part of getting older as many people think; rather, they almost always indicate a physical problem.

A key reason erectile dysfunction is considered a barometer for overall cardiovascular health is that the penis, the heart, is a vascular organ.

Because its arteries are much smaller than the heart’s, arterial damage shows up there first—often years ahead of heart disease symptoms.

Men in their 40s who have erection problems (but no other risk factors for cardiovascular disease) run an 80 percent risk of developing heart problems within 10 years.

Treatment tends to be successful when started as soon as you begin to notice erection problems over more than a couple of months. An ED workup by a doctor will address heart disease risk factors, such as prediabetes, high blood pressure or excess weight — hopefully, long before they result in a heart attack or stroke.

Heart Risk Factor: Low Testosterone

Having a low testosterone level is often thought of as just a diminished sex drive, but it’s increasingly seen as being linked to heart disease and type 2 diabetes, the expert says. He notes that a growing body of research indicates that “low T” can be considered a cardiovascular and metabolic risk factor.

“These ideas are still being studied, but we know, for example, that people with abdominal obesity [so-called ‘belly fat’] or metabolic syndrome often have low testosterone,” the expert says. Metabolic syndrome (which includes high blood sugar levels, unhealthy cholesterol levels, and too much weight in the midsection) and diabetes are leading risk factors for heart disease.

Low testosterone is simply one part of an overall picture of heart risk, the expert says. But it can be motivating, even lifesaving, to know that changes in your sexual function are closely interrelated to the rest of your body.

It’s worthwhile to get yourself checked out when something doesn’t seem right. “Men often don’t connect this problem to or get evaluated for stroke or heart attack risk until it happens,” he says.

“But sexual problems are a message they listen to.”

Research Shows

Men who have high levels of calcification in their arteries are more ly to develop erectile dysfunction, according to a Johns Hopkins–led study of nearly 1,900 men, aged 59 to 64, who were followed for nine years.

Calcification—calcium deposits in the arteries to the heart caused by damage—are a direct measure of blood vessel hardening, which indicates high cardiovascular disease risk. The men who were followed were heart-disease-free at the start of the study.

Those found to develop heavy calcium buildup were 43 percent more ly to develop erectile problems down the road.

The study emphasizes the importance of coronary calcium screenings, which are CT scans that measure calcium buildup in heart arteries.

Stress, anger and anxiety raise levels of blood pressure and stress hormones, and they can restrict blood flow to the heart. Some damage can be immediate. In the two hours after an angry outburst, for example, your risk of a heart attack is nearly five times greater and your risk of stroke three times higher, research has shown.

What’s more, the effects of chronic stress can build over time, damaging arteries. Men who have angry or hostile personalities, in particular, have a higher risk of developing heart disease. Sexual problems related to heart disease can cause added anxiety or relationship stress. Stress can also affect sleep, which in turn affects heart health.

“Physical, emotional and psychological factors are all related when it comes to heart health,” says a Johns Hopkins expert. “When someone has chronic stress, depression or anxiety, they should have a basic evaluation of all of the risk factors for heart disease.”

Source: https://www.hopkinsmedicine.org/health/wellness-and-prevention/special-heart-risks-for-men

Sexual Activity and Cardiovascular Disease

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

Sexual activity is an important component of patient and partner quality of life for men and women with cardiovascular disease (CVD), including many elderly patients.1 Decreased sexual activity and function are common in patients with CVD and are often interrelated to anxiety and depression.

2,3 The intent of this American Heart Association Scientific Statement is to synthesize and summarize data relevant to sexual activity and heart disease in order to provide recommendations and foster physician and other healthcare professional communication with patients about sexual activity.

Recommendations in this document are published studies, the Princeton Consensus Panel,4,5 the 36th Bethesda Conference,6–10 European Society of Cardiology recommendations on physical activity and sports participation for patients with CVD,11–13 practice guidelines from the American College of Cardiology/American Heart Association14–16 and other organizations,17 and the multidisciplinary expertise of the writing group. The classification of recommendations in this document are established ACCF/AHA criteria (Table).

Table. Applying Classification of Recommendation and Level of Evidence

Acute Cardiovascular Effects of Sexual Activity

Numerous studies have examined the cardiovascular and neuroendocrine response to sexual arousal and intercourse, with most assessing male physiological responses during heterosexual vaginal intercourse.

18–24 During foreplay, systolic and diastolic systemic arterial blood pressure and heart rate increase mildly, with more modest increases occurring transiently during sexual arousal.

The greatest increases occur during the 10 to 15 seconds of orgasm, with a rapid return to baseline systemic blood pressure and heart rate thereafter. Men and women have similar neuroendocrine, blood pressure, and heart rate responses to sexual activity.24,25

Studies conducted primarily in young married men showed that sexual activity with a person's usual partner is comparable to mild to moderate physical activity in the range of 3 to 4 metabolic equivalents (METS; ie, the equivalent of climbing 2 flights of stairs or walking briskly26) for a short duration.

Heart rate rarely exceeds 130 bpm and systolic blood pressure rarely exceeds 170 mm Hg4,18,27 in normotensive individuals. However, one study of normotensive men demonstrated substantial variations in peak heart rate and systemic blood pressure during orgasm.

23 Because most of the studies that assessed the cardiovascular effects of sexual activity were conducted in healthy men who were young to middle-aged, equating the myocardial oxygen demand of intercourse to climbing 2 flights of stairs is a generalization that may not characterize all individuals, especially those who are older, are less physically fit, or have CVD.

18 Therefore, it is probably more reasonable to state that sexual activity is equivalent to mild to moderate physical activity in the range of 3 to 5 METS, taking into account the individual's capacity to perform physical activity. Some patients, particularly older people,1 may have difficulty reaching an orgasm for medical or emotional reasons.

In attempting to achieve a climax, it is possible that such individuals may exert themselves to a greater degree of exhaustion with relatively greater demand on their cardiovascular system (although specific data on this are lacking).

Sexual Activity and Angina

Coital angina (“angina d'amour”), angina that occurs during the minutes or hours after sexual activity, represents

Source: https://www.ahajournals.org/doi/full/10.1161/cir.0b013e3182447787

New CDC data shows danger of coronavirus for those with diabetes, heart or lung disease, other chronic conditions

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

People who have chronic medical conditions, such as diabetes, lung disease and heart disease, face an increased chance of being hospitalized with covid-19 and put into intensive care, according to data released Tuesday by the Centers for Disease Control and Prevention that is consistent with reports from China and Italy.

The new data gives the most sweeping look at the way covid-19 is causing serious illnesses among people in the United States who already face medical challenges.

The report reinforces a critically important lesson: Although the disease is typically more severe among older people, people of any age with underlying medical conditions are at increased risk if they contract the virus, for which there is no vaccine or approved drug treatment.

The CDC data is an initial description of how the disease appears to be affecting people who are already dealing with health challenges.

The study did not break down the disease demographically, for example by age, sex, race or income.

The agency also notes that this is essentially a snapshot and can’t capture the ultimate outcome for people who have been infected with the virus and haven’t yet recovered.

The report shows covid-19 is thrusting vulnerable people in the United States into intensive-care units and disproportionately taking the lives of people who already face medical challenges.

The CDC analyzed more than 7,000 confirmed covid-19 cases across the country in which health officials had a written record about the presence or absence of any underlying medical condition.

The preexisting conditions covered in the records include heart and lung diseases, diabetes, chronic renal disease, chronic liver disease, immunocompromised conditions, neurological disorders, neurodevelopmental or intellectual disability, pregnancy, current or former smoker status, and “other chronic disease.”

The CDC found that, of people requiring admission to an intensive-care unit, 78 percent had at least one underlying health condition. Of people hospitalized but not requiring ICU admission, 71 percent had at least one such condition, compared with 27 percent of people who didn’t need to be hospitalized.

Among all the cases analyzed, 10.9 percent of patients had diabetes mellitus, 9.2 percent had chronic lung disease, and 9 percent had cardiovascular disease.

The report did not reach any conclusion about whether the severity of an underlying condition correlated to a more severe covid-19 illness.

Of the 7,160 patients whose chronic illness status was known through health records, 184 died, and 173 of them had an underlying condition, the CDC said. None of the deaths were among people under age 19.

Covid-19 is a respiratory disease. The virus typically infects the upper respiratory tract, but it can also venture deeper into the lungs and in some patients results in pneumonia- symptoms, requiring hospitalization and sometimes intubation on a ventilator. People who smoke or have chronic lung conditions are especially vulnerable.

Diabetes and heart disease are similarly worrisome. Someone already suffering from heart problems — whether they had previous heart attack or required a stent installed because of plaque buildup in their vascular system — may have a heart that cannot take as much strain as the average person, said Amesh Adalja, an infectious-disease physician at Johns Hopkins Center for Health Security.

When a patient gets infected with something this coronavirus, the fever causes a spike in the heart rate. Shortness of breath means the patient gets less oxygen. People with limited cardiac capacity can go into arrest.

Diabetes is a metabolic syndrome that involves blood glucose levels and affects how the immune system works, and makes it less effective, Adalja said.

“This is why patients with diabetes are at risk for many infections not just coronavirus,” Adalja said. “They often struggle with infections on their skin and soft tissues, with pneumonia and even more serious conditions.”

Those in the high risk group need to be extremely careful.

“If they do become infected, the threshold for them seeking medical attention needs to be much lower. They and their clinicians have to keep this in mind,” Adalja said. “These numbers show us just how crucial that is.”

Wilbur Chen, an infectious-disease physician at the University of Maryland School of Medicine, added that while the virus seems to prey on the elderly and sick, “it does not mean it does not cause severe illness in younger adults or in children — in other words, the risk is not zero among the young.”

He said, “We are now documenting a large number of covid-19 infections across the U.S. and we are now observing more and more of these ‘rare’ events of severe illness and even deaths among the young.”

“,”author”:”Joel Achenbach and closeJoel AchenbachReporter covering science and politicsEmailEmailBioBioWilliam Wan closeWilliam WanNational correspondent covering health, science and newsEmailEmailBioBioFollowFollow”,”date_published”:”2020-03-31T00:00:00.000Z”,”lead_image_url”:”https://www.washingtonpost.com/wp-apps/imrs.php?src=https://arc-anglerfish-washpost-prod-washpost.s3.amazonaws.com/public/54FY3WDJQUI6VMMZHKLZTRKFCI.jpg&w=1440″,”dek”:null,”next_page_url”:null,”url”:”https://www.washingtonpost.com/health/new-cdc-data-on-underlying-health-conditions-in-coronavirus-patients-who-need-hospitalization-intensive-care/2020/03/31/0217f8d2-7375-11ea-85cb-8670579b863d_story.html”,”domain”:”www.washingtonpost.com”,”excerpt”:”Report matches concerning pattern in China and Italy, with a warning for the chronically ill.”,”word_count”:742,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}

Source: https://www.washingtonpost.com/health/new-cdc-data-on-underlying-health-conditions-in-coronavirus-patients-who-need-hospitalization-intensive-care/2020/03/31/0217f8d2-7375-11ea-85cb-8670579b863d_story.html

Sex After Heart Disease: When Is It Safe to Get Back in the Saddle?

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

From the WebMD Archives

You've been treated for heart disease. You've followed your doctor's orders to a T. Now she says you're ready to get back to normal life. But does that include sex?

You know that clichéd yet haunting scene. Someone's having a fine time in bed. Then he clutches his heart and slumps over — and then it's, well, over. But here's the truth: You're more ly to have a heart attack while arguing with your mate than during sex, says Richard A. Stein, MD. He's a cardiologist at New York University School of Medicine in New York.

The media helps feed the idea that having sex after heart disease is risky. “The story goes back a long time,” Stein says. “The mythology is that at the time of sex, the time of orgasm, you have enormous cardiovascular effort and you put yourself at sudden risk of heart attack.”

But sex is really no harder on the body than climbing a few flights of stairs or briskly walking four or five blocks.

In fact, lots of people get the green light for sex within a week after they leave treatment, says Erin Michos, MD. She's an associate professor of medicine at Johns Hopkins University in Baltimore.

“Patients with heart disease that are stable are generally at very low risk,” she says.

Still, the subject makes many people afraid. But if you replace your fears with these tips, you can be snuggling again quicker than you think.

Get a Stress Test. This is sometimes called a treadmill test. You'll work out on a piece of equipment such as a treadmill or stationary bike while your doctor measures how well your heart keeps up with your body. There are several benefits to this:

  • You'll see firsthand what you can do, and you'll feel more confident.
  • If your spouse or partner goes along, they'll see your progress and feel more at ease about your physical health and strength.
  • Doctors often prescribe some type of cardio rehab after treatment. This test can double as a fitness check for rehab and for sex.

Be Open With Your Doctor. Most patients don't ask outright when they can start having sex. And many doctors don't freely offer that information. This creates an air of mystery or discomfort that helps no one.

Just because your doctor doesn't bring up sex doesn't means it's off the table. They could have their own hang-ups. For instance, a young doctor counseling an older couple might “see” his parents instead, without being aware of it, Stein says. “The doctors need to be comfortable,” he adds.

A task force is working to help doctors improve their skills when it comes to counseling patients about sex, Michos says. Their guidelines include not only follow-up physicals, but also advice and insights specific to the patient. This could include ideas for sexual positions that might work best for a couple or ways they can be intimate without having intercourse.

Light the Flame at Home. This isn't the best time to get fancy. At first, it's best to avoid having sex in a different place than you're used to. And if you're not married or in a monogamous relationship, try to stick with the same partner. The reason is simple. Being in a strange place or with a new person adds stress.

You should also avoid a heavy meal or alcohol before sex. Both can affect blood flow. Having a couple of drinks, or being anxious, “works against” you, Stein says.

If you think you need drugs to treat erectile dysfunction, ask your doctor. But you also need to be sure not to mix them with nitrate drugs, which are used to treat heart pain. That combo can be deadly.

Relax. Your chances of having a heart attack during sex are small. Some people are more ly than others to have one in the bedroom, Stein says. “In reality, those are the same people who have the heart attack after a fight with the boss or when going to a game and getting riled up.”

But if you have chest pain or find your heart isn't beating regularly, call your doctor right away and get checked out.

Put Sex in Its Place. It's natural. And it's an important quality of life issue for men and women, “a sign of healthy, intimate relationships,” Michos says. Studies show that decreased sexual function is often linked to anxiety and depression.

“When you have sex, the world doesn't move,” Stein says. For a couple who isn't having pain and can handle mild exercise, “sexual activity is absolutely a safe thing to do.”

SOURCES:

Richard A. Stein, MD, cardiologist, NYU Langone Medical Center; professor, New York University School of Medicine, New York.

Erin Michos, MD, associate director of preventive cardiology, Ciccarone Center for the Prevention of Heart Disease; associate professor of medicine, Johns Hopkins University, Baltimore.

American Heart Association: “Sex and Heart Disease.”

National Heart, Lung, and Blood Institute: “What to Expect During Stress Testing.”

American Heart Association: “Sex and Heart Attack: Talk with Your Doctor.”

National Institute of Alcohol Abuse and Alcoholism: “Beyond Hangovers: Understanding Alcohol's Impact on Your Health.”

Harvard Health Publications: “Are Erectile Dysfunction Pills Safe for Men With Heart Disease?”

Levine, G. Circulation, published online 2012.

© 2015 WebMD, LLC. All rights reserved.

Source: https://www.webmd.com/heart-disease/features/is-there-sex-after-heart-disease

Erectile Dysfunction: Symptoms and Treatment

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

Erectile dysfunction (ED), sometimes called impotence, is the inability to get or keep an erection firm enough for sexual intercourse. The condition has become highly visible in recent years, but that doesn’t make it any more welcome for the 5 to 15 percent of American men whose sex lives are affected.

The disorder can occur at any age, but is more common in men over age 75, according to the American Academy of Family Physicians (AAFP). In middle aged men, ED can signal risk of a heart attack, said Dr. David Samadi, the chairman of urology and chief of robotic surgery at Lenox Hill Hospital in New York City. 

The same cholesterol plaques that can build up in the arteries surrounding the heart can also affect arteries that go through penile tissue. Once doctors rule psychological causes, “they need to do a cardiac workup to make sure that this guy is not on the verge of getting a heart attack,” Samadi told Live Science.

Causes

Since sexual arousal is a complex process involving hormones, emotions, nerves, muscles, blood vessels and the brain, a malfunction in any of these can lead to ED. Stress, exhaustion and psychological issues can also contribute, and anxiety over maintaining an erection can actually make it harder to attain. In short, any condition that inhibits blood flow to the penis can lead to ED.

Aging is a large part of ED, but according to the AAFP and the Mayo Clinic, ED can also be caused by:

  • Heart disease or clogged blood vessels
  • High blood pressure
  • Diabetes
  • Obesity
  • Metabolic syndrome, a grouping of conditions that include high blood pressure, cholesterol and insulin levels and excess fat around the waist
  • Multiple sclerosis
  • Parkinson's disease
  • Low testosterone
  • Peyronie's disease, which is scar tissue inside the penis
  • Certain prescription drugs, such as antidepressants and high blood pressure medication
  • Smoking
  • Alcoholism or drug addiction
  • Prostate treatments
  • Brain or spinal cord injuries
  • Stroke
  • Radiation therapy to the testicles
  • Certain types of surgery on the prostate or bladder

The vast majority of ED cases are caused by disease, according to the National Institutes of Health (NIH), while drug side effects account for 25 percent.

Low libido, which is a low interest in having sex, should not be confused with ED, Samadi added. 

People often have drops in testosterone levels as they age, often called male menopause or “manopause,” Samadi said. 

Diagnosis & tests

Doctors can rule out various systemic causes of ED with a physical exam. Breast enlargement in men, for instance, can indicate hormonal issues, while decreased pulses in the wrists or ankles can suggest blood flow problems, according to the NIH.

Beyond that, several tests can lead to an ED diagnosis. According to the Mayo Clinic, these include:

  • Blood tests to check cholesterol, testosterone and glucose levels
  • Urinalysis to look for signs of diabetes
  • Ultrasound to check blood flow to the penis
  • Overnight erection test to monitor erections during sleep. Physical causes of ED can be ruled out if the patient has an involuntary erection while sleeping (a normal occurrence), breaking a special tape wrapped around his penis.

Medication & treatment

A variety of drugs and treatments are available for ED, from simple pills to complex surgeries. The cause and severity of ED will determine which treatment is recommended, according to the AAFP. Some treatments can have significant side effects.

Psychotherapy is an option to treat anxiety-related ED, according to the NIH. The patient's partner can help in the process of developing intimacy and stimulation.

Oral medications successfully treat ED in many men, Samadi said. These include sildenafil (commonly known by the brand name Viagra), tadalafil (Cialis), vardenafil (Levitra) and avanafil (Stendra). Each works by enhancing naturally occurring nitric oxide, which relaxes muscles in the penis and increases blood flow.

However, these medications should not be taken by men who take blood thinners, high blood pressure medicines, nitrate drugs for angina, or alpha-blockers for an enlarged prostate. According to the NIH, the combination of ED pills with these other prescription medications can cause a sudden, dangerous drop in blood pressure. 

Side effects include nasal congestion, headaches and a flushed face. If one medication doesn't work, another may do the trick. “We don't know why, but the chemistry of it may work differently on different people,” Samadi said. 

It's best to take oral medications on an empty stomach 60 to 90 minutes before having sex. If a person has a large meal, such as a steak dinner, the fatty food may absorb some of the medication and reduce its efficiency, except for Cialis, which stays in the body for a long time, Samadi said.

Other ED medications include:

  • Alprostadil injections, which produce an erection in five to 20 minutes that lasts for about an hour. Patients use a fine needle to inject alprostadil (commonly known by the brand names Caverject Impulse and Edex) into the base or side of the penis. Side effects can include bleeding or fibrous tissue formation at the injection site as well as prolonged erection, according to the Mayo Clinic.
  • Alprostadil penis suppository, which is inserted with a special applicator about 2 inches into the urethra. Side effects can include pain, minor bleeding, dizziness or fibrous tissue formation inside the penis.
  • Testosterone injections to raise low hormone levels.

If medications don't work, more aggressive treatments may be recommended, including:

  • Penis pumps, which involve placing a hollow tube over the penis and creating a vacuum that pulls blood into the penis with a hand- or battery-operated pump. According to the Mayo Clinic, a tension ring is placed around the base of the penis to maintain the erection until intercourse is finished.
  • Penile implants, which surgically places rods into the two sides of the penis that are inflatable when desired.
  • Surgery, which can repair arteries carrying blood to the penis or veins that allow blood to leave the penis.

Prevention

A variety of lifestyle choices can affect the ability to achieve and maintain an erection, so preventing ED is possible in some cases. Men are encouraged to manage chronic health problems with their doctors and to exercise regularly. They also should avoid smoking and excess alcohol and get help for anxiety or depression, according to the Mayo Clinic.

“There are a lot of benefits to healthy sexual function,” Samadi said, “Whether it boosts the immune system or whether it is good for releasing stress. So certainly, you don't need to give up on it just because you're getting older.”

Additional resources

Additional reporting by Laura Geggel. Follow her on @LauraGeggel. Follow Live Science @livescience, & .

Source: https://www.livescience.com/34724-erectile-dysfunction-disorder-symptoms-treatment.html

Am I having a heart attack?

Is Sex Dangerous If You Have Heart Disease? | Johns Hopkins Medicine

by Carolyn Thomas  ♥  @HeartSisters

NOTE FROM CAROLYN:  I wrote much more about cardiac symptoms and how to address them in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017).

You can ask for this book at your local library or favourite bookshop, or order it online (paperback, hardcover or e-book) at Amazon.

  If you order it directly from Johns Hopkins University Press (use their code HTWN), you will save 20% off the list price.

Before I was misdiagnosed with acid reflux in mid-heart attack and sent home from the E.R., I knew basically nothing about what a woman’s heart attack can feel .

And because of my mistaken heart attack stereotypes (old fat guy out on the golf course clutching his chest in agony, falling down unconscious), I believed the Emergency physician who confidently pronounced,“It is NOT your heart!”  But five months after surviving that heart attack,  I was shocked to learn this comprehensive list of women’s most common cardiac symptoms during my first trip to Mayo Clinic:

Warning signs of a heart attack:

  • ♥  an abrupt change in how you feel
  • ♥  pain, discomfort, pressure, heaviness, burning, tightness, ache or fullness in the chest, left or rightarms, upper back, shoulder, neck, throat, jaw or abdomen (generally, anyplace between neck and navel). These used to be called atypical cardiac symptoms when they happened to women. But women make up half of the population, so how can our symptoms be called “atypical”? Chest pain may be central, or felt “armpit to armpit”; in at least 10% of women, no chest symptoms at all are present during a heart attack. (1) 

NOTE FROM CAROLYN:  Study results on the absence of chest pain in women vary widely, ranging from about 8-42% depending on which study you read. For example, as Florida cardiologist and researcher Dr. John Canto explained to me via email (December 3, 2016): 

“Chest discomfort is the hallmark symptom for both women and women during myocardial infarction (MI, or heart attack).  But absence of chest pain is more commonly seen in women than men. On average, in our 2012 national study (1.

1 million MI patients, 465,000 of them female), 38% of women with STEMI did not have this hallmark chest pain symptom on presentation.

(2)  This is because (older) age is a major contributing factor to MI presentation without chest discomfort and more women who present with MI are older than men, on average by almost a decade.” 

But cardiologist Dr. Sharonne Hayes, founder of the Mayo Women’s Heart Clinic, told me that she now prefers to:

“. . .focus less on symptom DIFFERENCES (which multiple studies suggest are few and can’t be relied upon for diagnosis) and more on symptom RECOGNITION by patients and physicians, which continues to contribute to disparities in outcomes.”

  • ♥ weakness, fainting, light-headedness, or extreme/unusual fatigue
  • ♥ shortness of breath, difficulty breathing
  • restlessness, insomnia or anxiety
  • ♥ bluish colour or numbness in lips, hands or feet
  • ♥ clammy sweats (or sweating that’s proportion to your level of exertion or environment
  • persistent dry barking cough
  • ♥ a sense of impending doom

Not all of these signs occur in every heart attack.  Pay attention if these signs come on suddenly or feel unusual for you.  YOU KNOW YOUR BODY!! You know if something is “just not right”.

During my own ‘widowmaker’ heart attack, I was able to walk, talk, think, drive my car, go to work, and walk into the Emergency Department (where despite my textbook symptoms (central chest pain, nausea sweating and pain down my left arm), I was promptly misdiagnosed with acid reflux and sent home). More on this story here.

Sometimes heart attack symptoms go away – and then return. When they go away, it’s tempting to just shrug them off and go on with your day.  If they come back, seek help!

They usually come on with exertion, but may also appear when you’re at rest.

Women typically wait longer than men to call for help.  Find out why.  Don’t do this! 

Ask yourself what you would do if these exact symptoms were happening to your daughter or your Mum or your sister. Then do that for yourself.

LISTEN to your body.  DON’T IGNORE symptoms.  GET HELP fast.

Women often experience other ‘non-classic’ symptoms that are not immediately associated with heart concerns – symptoms that can appear weeks before the actual cardiac event.

 An Oregon study found that up to 95% of women experience early warning signals (called prodromal symptoms) weeks or even months leading up to their cardiac event.

Researchers reported that female heart attack survivors often reported these warning symptoms before the attack:

  • 70% reported severe, unexplained fatigue
  • 48% had sleep disturbances
  • Almost half had shortness of breath, indigestion and anxiety
  • Almost half had no chest symptoms

and during the attack:

  • 50%  had shortness of breath and weakness
  • 50%  had extreme fatigue, cold sweats and dizziness

Despite these findings, the Heart & Stroke Foundation notes that chest pain is still the most common warning sign in both sexes.

What to do if you’re having these symptoms:

  • Immediately call 911 and say: “I think I’m having a heart attack!” Do not apologize for being a bother. Do not self-diagnose by saying something : “It’s probably just a pulled muscle, indigestion, stress…” etc.


  • Chew one full-strength uncoated aspirin tablet (with water if you ) while you’re waiting for the ambulance. NOTE: Some people should not take aspirin if they’re on certain drugs, or are allergic to aspirin, or have a sensitivity to aspirin.

    Check with your doctor, and if you’re one of these people, skip this step.

  • Unless absolutely unavoidable, do not drive yourself to the hospital – and do not ask a friend or family member to drive you there.

      Ambulance paramedics can start an EKG, administer life-saving meds, and call ahead to the Emergency Department to minimize dangerous delays.

See also:

-I recommend the medical website Up To Date which has a basic patient-friendly section all about chest pain, with some useful tips on telling the difference between chest pain that is ly heart-related, and chest pain that is NOT.

-Watch this 22-minute documentary called “A Typical Heart“, a remarkable Canadian film about the deadly disparity between male and female heart disease, as experienced through the lens of healthcare professionals, researchers, patients, and their families (Disclaimer: I was one of the eight Canadian heart patients interviewed).

-Make the Call – Don’t Miss a Beat is a women’s heart attack symptom awareness campaign

-How does it feel to have a heart attack? Women survivors tell their stories

-This is NOT what a woman’s heart attack looks

-Researchers openly mock the ‘myth’ of women’s unique heart attack symptoms

-Is this heartburn or heart attack?

Learn more about signs and symptoms of women’s heart attacks from The Heart Truth, the Heart & Stroke Foundation’s campaign to educate women about heart disease

Get help translating confusing heart disease terminology, phrases and jargon

If you or somebody you know has been diagnosed with heart disease, you can find support from other heart patients in the comfort of your own home by joining the free 24/7 online support community hosted by WomenHeart: The National Coalition For Women With Heart Disease, or participate in one of three free regularly scheduled WomenHeart virtual support groups for women living with atrial fibrillation, heart failure or heart disease.

(1)  S. Dey et al, “GRACE: Acute coronary syndromes: Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events”, Heart  2009;95:1 20–26.

(2) J. Canto et al, “Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality,” JAMA. 2012 Feb 22;307(8):813-22.

Updated January 10, 2020

Source: https://myheartsisters.org/about-women-and-heart-disease/heart-attack-sign/