Dr Sarah shares the symptoms of a heart attack


Our hearts are one of our most vital organs. But do you know the heart attack warning signs to look out for?

According to the Heart Foundation, nearly 2% of people will experience a heart attack at some point in their life. Heart attacks are one of many conditions that sit under the cardiovascular disease (CVD) umbrella, which sadly takes the life of one in every four Australians. 

We spoke with Dr Sarah Zaman – Associate Professor and Academic Interventional Cardiologist at The University of Sydney and Westmead Applied Research Centre – to learn the symptoms of a heart attack and what proactive steps can be taken to reduce the chance of a heart attack.

What is a heart attack?

A heart attack can occur when the blood flow that brings oxygen-rich blood to the heart muscle is severely reduced or cut off. This blockage is usually caused by a buildup of fat, cholesterol, and other substances (plaque) that narrows coronary arteries – known as coronary artery disease.

During a heart attack, this hardened plaque ruptures, forming a blood clot that not only blocks the flow of blood but can also cause significant damage to the heart muscle itself.

But a heart attack may also occur when a coronary artery contracts and narrows severely, causing blood flow to reduce or stop suddenly. 

Ultimately, a heart attack stops normal blood flow levels and lowers the amount of oxygen that reaches the heart. Not surprisingly, heart attacks can be fatal and need to be treated as a medical emergency. 

Heart attack symptoms: why the symptoms differ between men and women

When it comes to symptoms of heart attacks, chest pain is usually the most common. Often described as heavy, crushing, or significant pressure to the chest, this symptom is experienced in both males and females.

Other symptoms of heart attack include:

  • Pain, tightness, or discomfort in your arms, shoulder, neck, back and jaw
  • A burning sensation in your chest (similar to the feeling of heartburn or indigestion)
  • Shortness of breath
  • Nausea or vomiting
  • Dizziness
  • Tiredness or fatigue

While almost 2% of people will experience a heart attack sometime in their life, twice as many men experience heart attacks compared to women.

But that’s not the only gendered difference of heart attack symptoms. In fact, women are more likely to experience no chest pain at all.

“Heart attacks can present differently in women and men. For example, women may feel that their pain is not typical of heart attack pain. However, most women (about 90%) with a heart attack do describe some sort of chest pain, which might be central chest pain, pressure, tightness, an ache in the chest or a burning pain. This pain may also be felt in the left arm, both arms or the neck and jaw,” Dr Sarah shares.

Instead, women may experience discomfort that feels like indigestion and are more likely to have shortness of breath, fatigue, and insomnia in the lead-up to a heart attack.

“The other difference is that women may have more 'associated symptoms' than men. This means that on top of chest pain, they may have additional symptoms such as dizziness, nausea, vomiting, sweatiness or back pain,” Dr Sarah says. 

Other common heart attack symptoms in women include:

  • Uncomfortable pressure, squeezing, fullness, or pain in the centre of your chest that may last more than a few minutes or go away and come back
  • Pain or discomfort in one or both arms, neck, jaw, or stomach
  • Pain in the back; specifically between the shoulder blades
  • Sweating
  • Shortness of breath with or without chest discomfort
  • Breaking out in a cold sweat, nausea or lightheadedness
  • Lethargy, particularly when accompanied by chest pain or discomfort

Though heart attacks tend to conjure images of sudden and intense pain with someone clutching their chest and keeling over, the reality is that symptoms can often start slowly, with mild pain or discomfort. For this reason, it’s important to not only understand the symptoms of heart attack but also pay attention to your body and call 000 should you experience any of the above. 

However, Dr Sarah is quick to point out that there is a bigger potential issue at play: “The other larger [gendered] problem is that often women do not feel they are at risk for heart attacks, and clinicians may see women to be at lower risk and not consider a heart attack as a cause of the symptoms.”

Lower your risk: how to proactively prevent the likelihood of a heart attack

When it comes to risks associated with heart attack, primary factors can include diabetes, obesity, high blood pressure, smoking, family history of heart attack, high cholesterol, and low household income.

While there are risk factors outside our control, there are practical lifestyle changes that can be made to lower the chance of a heart attack and boost overall heart health. From achieving a healthy weight to addressing an unhealthy diet, discover the practical ways you can live a full, active life by fostering a heart-healthy lifestyle.

Dr Sarah explains that there are three practical steps every Australian can take to lower their risk of a heart attack, which include:

  • Maintain a healthy lifestyle by “keeping physically active such as walking, going to the gym, cycling or swimming.”
  • Prioritise a balanced diet by “eating a healthy diet with lots of fresh whole foods, fruits and vegetables, healthy fats, and minimal processed or takeaway junk food.”
  • Know your numbers by “having regular yearly blood tests to check your cholesterol and diabetic markers (and receive treatment where needed) and very importantly, have your blood pressure checked regularly—and receive treatment where needed.”

Plus, there are other lifestyle changes and proactive steps you can take to foster good heart health.

Lower your cholesterol

While there’s good cholesterol in the form of high-density lipoprotein (HDL), which helps remove other forms of cholesterol from your bloodstream, the bad stuff (known as non-HDL) can greatly increase your risk of coronary heart disease.

Non-HDL can clog up your arteries and prevent blood flow to the heart, making it a significant risk factor for heart attack.

However, lowering your cholesterol can greatly reduce the likelihood of heart attack. By limiting the amount of butter, cheese, full-fat milk and meat in your diet, you can focus on maintaining healthy cholesterol levels.

In practice terms, consider boosting your intake of olive oil, oily fish, and nuts and ensuring you get the recommended 2.5 hours of moderate exercise into your routine each week.

Keep blood pressure down

High blood pressure is a leading risk factor for heart attack, so it’s important to keep it down. The heart already has to work hard to pump blood around the body, but high blood pressure places greater strain on it and can make it less effective at pumping blood. In some cases, it can even lead to heart failure.

When it comes to keeping blood pressure down, the first step is to consult your GP. While it’s important to always seek personalised medical advice, some general tips for supporting healthy blood pressure levels can include:

  • Cutting back on salt and sodium in your diet
  • Reducing your alcohol intake to less than one drink a day for women or two drinks a day for men (one drink equals approximately 350mL of beer or 147mL of wine)
  • Eating healthy and balanced diet rich in whole grains, fruits, and vegetables
  • Aiming to get seven to nine hours of sleep every night
  • Easing stress by taking time to relax and even meditate
  • Staying physically active and engaging in regular exercise

Watch your weight

Excess fat around your midsection can place you at greater risk of coronary heart disease, making it crucial to watch your weight. Consult your GP for personalised health advice, and consider sticking within the recommended BMI for your age group and height.

Keep Reading: Discover five superfoods to incorporate into your diet.

Avoid smoking

Smoking tobacco is named as the top cause of preventable disease and death in Australia, responsible for over one-third of all CVD deaths in Australia for people aged less than 65.

Due to the chemicals found in cigarettes, smoking can cause significant damage to the arteries, putting more strain on your heart and increasing the risk of blood clots. Your risk of coronary disease decreases the moment you stop smoking, making it one of the most effective proactive measures to reduce your likelihood of heart attack.

Be mindful during pregnancy

With women experiencing different heart attack symptoms compared to men, pregnancy also poses a significant risk. In fact, pregnancy is often seen as the “ultimate stress test” for the body, with blood flow increasing by up to 50% during this time. 

It’s important that expectant mothers enter pregnancy in as healthy a state as possible. The risk of heart attack can be lowered greatly before conceiving by taking up regular exercise, following a healthy diet, and quitting smoking.

Manage diabetes

Adults with diabetes are nearly twice as likely to have heart disease or stroke  as adults without diabetes. This is largely a result of high blood glucose, which can damage your blood vessels and the nerves that control your heart and blood vessels. Over time, this damage can lead to heart disease.

Taking care of your diabetes is crucial to protect your heart. Be sure to manage your A1C test, which shows your average blood glucose level over the past three months, as well as your blood pressure and cholesterol. Plus, people with diabetes should consider quitting smoking as soon as they are able to as both narrow blood vessels, so your heart has to work harder.

Keep Reading: Learn 10 practical tips to improve your health and wellbeing today. 

Discover other ways to protect your health

Ultimately, the more you know about how your heart works, the better you are at spotting the signs of a heart attack and preventing it in the first place.

Along with lowering your stress levels, fostering a balanced diet and getting enough exercise, there are other ways to proactively take care of your health.

Having the appropriate level of health insurance in place gives you peace of mind that comes with knowing you’ll have protection in place when you need it most. Learn more about Real Health Insurance  and request a quote today.

Associate Professor Sarah Zaman

Dr Sarah Zaman

Associate Professor Sarah Zaman is an Academic Interventional Cardiologist at Westmead Hospital and the Westmead Applied Research Centre, University of Sydney, Australia. A/Prof Zaman has been recognised as a national leader in academic cardiology and has been the recipient of the prestigious National Heart Foundation Future Leader Fellowship and NSW Elite Post-doctoral Grant. 

A/Prof Zaman has a PhD from the University of Sydney, targeting the prevention of sudden cardiac death. She also leads a Women’s Heart Disease Research Program at the University of Sydney focused on healthcare inequities in heart attack care for women and female-predominant cardiac conditions. 



This article is an opinion only, provided for general information purposes and should not be relied upon as personal advice. You should seek the advice of your physician or other qualified health care professional before starting any fitness or dietary program to determine if it is right for your needs.