Do you ever feel like you’re giving out so much, for example to your family, career and/or your communities, that you feel like you overlook your own needs?
The thing is, this can mean that we end up disregarding the needs of the one organ in particular that keeps us going strong – our heart.
Heart disease is the number one killer of women, claiming more lives than all cancers combined, according to the CDC, however it’s often misunderstood because our symptoms can look so different from the ‘classic’ signs we see in movies or hear about in men. As a healthy-heart coach who’s passionate about empowering women to take charge of their wellness, I feel it’s time to share with you exactly what heart disease symptoms look like in women 1, why they’re often sneaky, and what you need to be aware of to protect your beautiful heart.
Let’s dive into this heart-to-heart conversation about keeping your heart thriving, rather than simply surviving.
Why heart disease symptoms are different for women
First things first – heart disease doesn’t seem to ‘play fair’, especially when it comes to women. You’ve probably heard about the ‘Hollywood heart attack’—that dramatic chest-clutching, collapse-on-the-floor moment that screams heart trouble.
While that can happen, it’s often not how heart disease shows up for us. Women’s symptoms are frequently subtler, more varied, and—let’s be real—easier to brush off as ‘just stress’ or ‘I must be tired.’
Why is this? It’s a mix of biology and bias. Our hormones, like oestrogen (in particular oestrodiol), offer some heart protection before menopause, however as those levels drop, our risk spikes. Plus, women’s hearts and blood vessels are smaller, and we’re more likely to develop conditions like microvascular disease, where tiny heart arteries get blocked instead of the big ones, leading to less obvious symptoms.
On top of that, medical research has historically focused on men, so doctors—and even we ourselves—might not always recognise women’s symptoms as heart-related. A 2021 study in Circulation found that women are 50% more likely than men to be misdiagnosed during a heart attack, often because our symptoms don’t match the textbook. This means we need to be our own advocates, tuning into our bodies and knowing what to watch for.
The sneaky symptoms you need to know
Heart disease in women can show up in ways that feel vague, confusing, or downright deceptive, so let’s break down the symptoms you should be aware of. These can signal anything from angina (chest pain from reduced blood flow) to a heart attack or other cardiovascular issues.
Here’s what to watch for, with a focus on what makes women unique –
• Unusual fatigue – We’re not talking about the ‘I feel like I’ve been chasing my tail all day’ kind of tired. This is a bone-deep exhaustion that feels out of proportion, like you can’t get out of bed or even climbing a flight of stairs wipes you out. A 2020 study in The Lancet noted that 70% of women reported extreme fatigue in the weeks leading up to a heart attack—way more than men.
• Chest discomfort (however not always pain) – While men often describe crushing chest pain, women might feel a subtle pressure, tightness, squeezing, or burning in the chest that comes and goes. It might not scream ‘heart attack’ however could feel like indigestion or a heavy weight. Pay attention if it’s new or persistent.
• Pain in unexpected places – Women are more likely to feel pain in the jaw, neck, throat, upper back, or even arms (especially the left one). It might feel like a dull ache, a sharp stab, or just an odd sensation that doesn’t go away. A 2022 Journal of the American Heart Association study found that 62% of women with heart attacks reported jaw or back pain as a primary symptom.
• Shortness of breath – Feeling like you aren’t able to catch your breath, even when you’re sitting still or doing light activity, is a red flag. This can happen with or without chest pain and is especially common in women, per a 2021 European Heart Journal report.
• Nausea, sweating, or dizziness – These can feel like you’re coming down with the flu or having a panic attack, however they’re common heart attack symptoms in women. Cold, clammy sweats or sudden nausea—especially paired with other signs—shouldn’t be ignored.
• Heart palpitations – If your heart feels like it’s racing, fluttering, or skipping beats, especially if it’s new or paired with dizziness or fatigue, it could signal an arrhythmia or other heart issue. Women are more prone to stress-induced palpitations, which can escalate if untreated.
• Swelling or discomfort in the abdomen – This is less talked about however critical. Some women experience bloating, abdominal pain, or a feeling of fullness that’s linked to heart failure, where the heart struggles to pump blood effectively, causing fluid build up.
These symptoms might not hit all at once, and they can wax and wane, making them easy to dismiss. The key is to trust your gut—if something feels ‘off’ and doesn’t resolve with rest, it’s time to act.
Women’s intuition is powerful, and it could save your life.
Risk factors that amplify symptoms
Knowing the symptoms is half the battle, however understanding what puts you at risk can help you stay proactive. Heart disease risk factors hit women differently, and some are unique to us.
Here’s what to keep on your radar –
• Hormonal shifts – Menopause drops oestrogen levels, which can increase cholesterol and blood pressure, making symptoms more likely. If you’ve had early menopause (before 40) or a hysterectomy, your risk is even higher.
• Autoimmune conditions – Women are more likely to have diseases like lupus or rheumatoid arthritis, which increase inflammation and heart disease risk, as noted in a 2023 Nature Reviews Cardiology study.
• Pregnancy-related issues – Conditions like preeclampsia, gestational diabetes, or preterm delivery can raise your long-term heart disease risk by up to 2 times, per a 2021 American College of Cardiology report.
• Mental health stressors – Anxiety, depression, and chronic stress are more common in women and directly impact heart health. A 2022 Circulation study linked depression in women to a 44% higher risk of cardiovascular events.
• Lifestyle factors – Smoking, obesity, a sedentary lifestyle, and poor diet amplify your risk. Women who smoke, for example, have a 25% higher risk of heart disease than men who smoke, per the CDC.
If you have one or more of these risk factors, be extra vigilant about symptoms and talk to your doctor about regular heart health screenings, like blood pressure checks, oxidised-cholesterol tests, or an ECG.
What to do if you suspect heart trouble
If you’re experiencing any of the symptoms above, don’t wait—time is critical with heart issues.
Here’s a step-by-step guide to take action, designed with women in mind –
• Trust your instincts – If you feel something’s wrong, don’t brush it off as ‘just stress’ or ‘overreacting.’ Women often delay seeking help due to self-doubt, however a 2021 Journal of the American College of Cardiology study showed that women who sought care promptly had better outcomes.
• Call for help – If symptoms like chest discomfort, shortness of breath, or extreme fatigue last more than 5–10 minutes or worsen, call 111 (or your local emergency number) immediately.
Say, ‘I think I’m having a heart attack,’ to ensure priority care. Don’t drive yourself to the hospital—paramedics can start treatment en route.
• Be your own advocate – When you get to the ER, clearly describe your symptoms, even the vague ones, and mention that women’s heart attack symptoms can differ from men’s. If you feel dismissed, politely insist on tests like an ECG, blood tests for troponin (a heart damage marker), or a stress test.
• Keep a symptom log – Before you see a doctor, jot down what you’re feeling, when it started, and how long it lasts. Include details like whether it’s triggered by activity or stress. This can help your doctor pinpoint the issue faster.
• Follow up – If you’re sent home however still feel off, schedule a visit with a cardiologist who specializes in women’s heart health. Ask about tests like a coronary calcium scan or a cardiac MRI to catch issues early.
Acting fast can mean the difference between a full recovery and serious complications, so don’t hesitate to prioritise yourself.
Fresh strategies to protect your heart
Now that you know the symptoms and risks, let’s talk about empowering ways to keep your heart strong and reduce the chances of those scary symptoms popping up. I’m skipping the usual advice (you won’t see ‘eat more kale’) and sharing fresh, women-focused strategies that are practical, science-backed, and designed to fit your busy life.
• Practice heart-focused visualisation – This is a powerful mind-body technique to calm your nervous system and support heart health. Each morning, spend 5 minutes closing your eyes and picturing your heart glowing with strength and vitality, surrounded by warm, healing light. A 2023 study in Psychosomatic Medicine found that visualisation lowered stress markers by 18%, easing strain on the heart.
• Incorporate adaptogenic herbs – Instead of just focusing on diet, trial herbs like rhodiola or hawthorn berry, which have been shown to support cardiovascular health and reduce stress-induced inflammation. Add rhodiola to a morning smoothie or sip hawthorn tea in the evening—both are backed by a 2022 Journal of Herbal Medicine study for their heart-protective benefits.
• Trial low-impact strength training – Forget high-intensity workouts if they’re not your thing. Gentle strength training, like lifting light weights or doing bodyweight exercises (think squats, planks or wall push-ups), improves circulation and strengthens your heart without overtaxing it. A 2021 European Heart Journal study showed that 2–3 sessions a week reduced heart disease risk in women by 15%.
• Create a heart-healthy playlist – Music can be medicine for your heart. Curate a playlist of uplifting, calming songs that make you feel empowered or relaxed. Listen during your commute or while cooking. A 2020 American Journal of Cardiology study found that music lowered blood pressure and heart rate in women with high stress.
• Schedule ‘heart check-ins’ – Once a week, set aside 10 minutes to check in with your body. Sit quietly, place a hand over your heart, and notice how you feel—physically and emotionally. Are you fatigued?
Stressed?
Short of breath?
This practice builds body awareness, helping you catch subtle symptoms early. Pair it with a journal to track trends.
• Explore osteopathy and acupressure for heart health – Osteopathy, a non-invasive, gentle treatment approach with a variety of techniques, can help to normalise the functioning of the nervous and cardiovascular systems.
Acupressure, a needle-free version of acupuncture, can reduce stress and improve circulation.
• Build a women’s heart health network – Connect with other women to share stories, tips, and support. This could be a local women’s health group, an online community, or even a monthly cuppa date with friends where you talk about wellness goals.
Social support reduces heart disease risk by 20%, per a 2021 Circulation study, and it’s empowering to know you’re not alone.
These strategies aren’t just about prevention—they’re about celebrating your strength and making heart health feel like an act of self-love.
Building a heart-healthy future
Heart disease might be a leading threat, however it’s not your destiny. By knowing the symptoms—those sneaky ones like fatigue, jaw pain, or nausea—and understanding your unique risks as a woman, you’re already taking a huge step toward protecting your heart.
Combine this with proactive strategies like visualisation, adaptogenic herbs, osteopathy, gentle exercise, music, acupressure, and community, and you’re building a lifestyle that keeps your heart strong and vibrant.
However the most important thing?
Trust yourself. You know your body better than anyone, and if something feels off, don’t hesitate to speak up, seek help, and advocate for the care you deserve.
As women, we’re often taught to put others first, however your heart is the foundation of everything you do—your dreams, your relationships, your joy. So, let’s make a pact, you and I, to listen to our hearts, honour their signals, and give them the love they need to keep beating strong.
You’re worth it 🙂
See you on this week’s #AlivewithFi 🙂
1 The Mayo clinic has some useful insights – https -//www.mayoclinic.org/diseases-conditions/heart-disease/in-depth/heart-disease/art-20046167
Fi Jamieson-Folland D.O., I.N.H.C., is The LifeStyle Aligner. She’s an experienced practitioner since 1992 in Europe, Asia and New Zealand as a qualified Osteopath, Integrative Nutrition Health Coach, speaker, educator, writer, certified raw vegan gluten-free chef, and Health Brand Ambassador.
