Heart disease is the No. 1 killer of women in America annually and since 1984, more women than men have died from cardiac conditions, according to Go Red for Women, a branch of the American Heart Association.

Another difference between women and men? Warning signs for women often don't resemble a "Hollywood heart attack," or one preceded by highly recognizable symptoms like crushing chest pain and a sharp pain in the left arm, said Dr. Stacey E. Rosen, vice president of Women's Health for the Katz Institute of Women's Health at North Shore LIJ.

The fact is, she said, a woman's symptoms for heart attack look very different, typically occurring in "mini-episodes" that come and go over hours, days or even weeks. As a result, women tend to wait longer to seek care than they should, explaining away warning signs and attributing them to lesser problems, Rosen said, citing a study in the Canadian Journal of Cardiology.

Take a look at seven symptoms of heart attack that Rosen says every woman should know.


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Women are about twice as likely to experience heartburn-like symptoms as a result of heart disease, including belching, indigestion and nausea, Rosen said. It’s "pretty easy to make an excuse" for that, she said, saying a women might think, "you know, 'I had tacos at lunch.'" To explain the difference between a case of heartburn versus something more serious, the Mayo Clinic said, "Occasional bouts of heartburn are common. If you have persistent heartburn or take antacids daily, consult your doctor."


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Quality of sleep may influence a woman's risk of heart disease, according to an article by Go Red For Women, which attributes the risk to inflammation, "a well-known predictor of cardiovascular health" and a common side effect of sleep deprivation and insomnia. Rosen said the problem for women is sleep deprivation is commonly associated with other health or life factors. "Sometimes for middle-aged women, around menopause, there are sleep disturbances that go along with menopause."


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Rosen said women tell her they, "just don't feel right" -- sometimes attributing it to a panic attack. She added that patients also describe an "overwhelming feeling of doom,” a symptom they often link to having a presentation due at work or a similar important event. Both heart disease in women and panic attacks are associated with feelings of anxiety, which can be dangerous. A panic attack, like heart disease often comes with shortness of breath, anxiety, palpitations and indigestion. If symptoms last for more than two to three minutes or if the pain leaves and then returns, it could be heart disease, according to the Women's Heart Foundation, and you need to call 9-1-1.


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Women may feel a lack of energy, Rosen said, adding that her patients will often describe an "inability to do their usual activities." Often, she said women attribute their fatigue to being busy, having extra activities to complete with their families, or added expectations at work. Citing a study that canvassed 500 women who survived heart attacks, the Harvard Medical School said that 95 percent of women noticed something "wasn't right," with fatigue being one of the most common signs. "Some women, for example, said they were so tired they couldn't make a bed without resting," the study says.

Widespread pain

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Women who experience pain -- originating from anywhere in the body -- should be on alert, but those symptoms “can sometimes feel flu-like," Rosen said. "Sometimes it's back pain or neck pain, and again it's easy for any of us to just sort of blow that off." Go Red For Women specifies pain or discomfort in one or both arms, the back, neck, jaw or stomach as warning signs of a heart attack.

Shortness of breath

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The American Heart Association cites shortness of breath is a typical warning sign of a heart attack, saying it could feel like you “ran a marathon” but haven’t moved at all. Rosen said the problem for women is, "it's easy to make excuses -- 'Oh, I've got allergies' -- that sort of stuff."

Excess perspiration

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Another symptom of a heart attack, Rosen said, is sweating. "Some women will perspire more," she said, explaining that women may break out in a cold sweat. Sweating, among other symptoms, is something the Go Red For Women campaign says "women often brush off as the flu, stress or simply feeling under the weather. ”

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