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Nurse’s Tweet Highlights Issue Recognizing Heart Attacks in Women With Chronic Pain


There are “classic” heart attack symptoms like chest pain and left arm pain or numbness, but heart attacks do not always present in the most obvious manner, especially for women. In a viral tweet thread, a nurse shared the heart attack symptoms she thought at first were caused by a muscle strain.

She said she never had chest pain, but experienced a “burning and aching” in her upper back, both arms and shoulder blades. The pain wasn’t clear enough to indicate a heart problem, so the nurse thought it was muscle strain from helping her neighbor clean out her barn.

After she woke up drenched in sweat and vomiting, she realized something else was going on and called 911. She was able to get four stents put in place to help with the artery blockage and spent a few days in the hospital recovering.

Symptoms of heart attacks can be more subtle, and the “classic” symptoms typically advertised are more recognized in men than women. Classic symptoms include pain in the left arm, chest pain or the feeling of an “elephant” sitting on your chest.

“Women could potentially have much more subtle symptoms — things like shortness of breath, jaw pain, back pain, nausea, vomiting, fatigue — and so women aren’t always sure the same way as men if they’re actually having a cardiac issue,” Dr. Suzanne Steinbaum, D.O., cardiologist and director of women’s cardiovascular prevention health and wellness at Mount Sinai Hospital in New York, told The Mighty.

Other symptoms of heart attacks more likely to be present in women include dizziness, sweating or other flu-like symptoms. Pain and discomfort sensations can feel like they’re coming from other parts of your body like your back, as happened for this Twitter user.

Because the symptoms can seem vague or are easily shrugged off as something less sinister like a muscle strain, it can be hard to recognize a heart attack. This is especially true for women who also live with chronic pain.

Steinbaum said people with chronic pain should take note of any changes in their pain, base activity level and anything else out of the ordinary that may signal something other than a typical flare. If you’ve identified a pattern or triggers with your chronic pain, consider seeing a doctor if it changes.

“When there’s chronic pain involved,” Steinbaum added, “It’s so hard to tease through, ‘Is this just my usual thing acting up or is it my heart?”

People with inflammatory issues, like an autoimmune disorder, should be aware that this increases their risk of heart disease, Steinbaum said. It’s important to discuss heart health along with issues specific to your chronic illness at the doctor’s office.

Heart attacks don’t typically come out of nowhere either, Steinbaum said. It’s usually associated with a plethora of risk factors like family history, high blood pressure, high cholesterol and smoking. Knowing these risk factors and checking your numbers like your blood pressure is good for tracking your risk.

There’s no steadfast way to discern if your symptoms are a heart attack or an issue related to your chronic pain or illness. If you experience a new symptom like pain in a different area or a worsening symptom like fatigue, it may seem logical to chalk it up to your chronic illness, but it’s a good idea to double check.

Photo via Getty Images/Jolygon