The actual symptoms of a heart attack that women have no idea about.

If you were to ask the average woman to list the symptoms of a heart attack, she would likely answer without drawing breath.

Tightness in the chest. Pain in the left arm. She might self-consciously laugh about a ‘smell of burning toast’.

And sure, she’s half right. But there’s just one problem.

They’re the symptoms of heart attack in men.

Not women.

As the Courier Journal puts it, “until recently, heart disease was considered a man’s disease.” One of the reasons is that men tend to have heart attacks younger, their first at age 65, whereas women on average don’t experience heart attack until 72.

But here’s the often ignored footnote.

The survival rates of a heart attack are actually worse in women, and just like men, one in three women will lose their life to heart disease.

By their late 70s, women are eight times more likely to die of heart disease than breast cancer.

So, why aren’t we talking about it?

According to Dr Brad McKay, conventional wisdom has been shaped by the “standard straight white male studies done in the past,” meaning that when women present with worrying symptoms, many doctors don’t immediately jump to a heart attack.

“Symptoms for men will be crushing chest pain,” Dr McKay told Mamamia. “Men will often say it feels like an elephant is standing on their chest. Or somebody has tied a belt around their chest and it’s tightening around their back, that’s really classic…”

For women, it’s a different story.

So, what are the symptoms of heart attack in women?

Dr McKay said the classic signs will emerge during exercise.

“Their heart is put under more pressure as it’s beating faster, and there’s less oxygen able to get to the tissue of the heart because there can be blockages in the arteries… [women] might find that they’re a bit more fatigued sooner… or if they’re used to walking to the top of a hill, then they might need to stop halfway because they’re getting odd symptoms,” he explained.

“Women will have shoulder pain.

“They might have pain between their scapula, their shoulder blades at the back and they can have tightness or discomfort. But the whole thing about women is that they have breasts – so they might feel pain and discomfort that pulls on different parts of the chest.

“Often women will think ‘Oh yeah, my breasts are just in the wrong position or they’re pulling, or my bra is just a little bit tight today…’ and it won’t actually click that it’s not their breasts causing the problem but it could actually be their heart lying underneath,” Dr McKay said.

Sixty per cent – a majority – of women do not report chest pain when experiencing a heart attack. Instead, they might feel nauseous or think they’re suffering from gastro.

Dr McKay said that the main thing to look out for is “anything out of the ordinary”.

For some, there will be “pain in their neck, up to the angle of the jaw… if it’s going up to the eyes then it’s not likely to be a heart attack.”

If any pain is felt in the arm, it will be towards the inside. If it’s on the outside (near the tricep) then, according to Dr McKay, that usually indicates neck pain, or some sort of neck issue.

What are the risk factors of heart attack for women?

The risk factors for women include:

• High blood pressure
• If you’re overweight or obese
• High cholesterol
• If you’re a smoker
• Diabetes
• Lack of exercise
• Family history – particularly if someone in your family was under 55 years old when they first developed heart disease or had a stroke
• A personal history of heart attack or stroke

An additional problem with diagnosis in women, is that doctors are less likely to check cholesterol in women, which means risk factors are not picked up.

And as for the burning toast myth?

“That’s not something ever taught at medical school it’s just really weird,” Dr McKay said, laughing.

“That’s not a thing.”