5 Surprising Signs of Heart Disease in Women, According to Experts
Key Points
When most people think of a heart attacl, they picture the classic movie scene of someone clutching their chest, running out of breath and collapsing to the floor. But in real life, it’s often much less obvious. And heart disease? Even more subtle. “Heart disease isn’t just isolated in the heart. It influences the whole body, which is why you might experience body-wide early signs,” says a Dr., “Many of the early signs and symptoms of heart disease are related to chronic inflammation, reduced oxygen delivery or fluid buildup due to the heart’s reduced pumping ability.”
Some of the earliest signs of heart disease can be overlooked because they show up in places you wouldn’t expect. For women especially, symptoms of heart disease may be explained away as stress, fatigue and sometimes mistaken for normal hormonal shifts, like those that happen during menopause. That’s exactly why paying attention to subtle changes and advocating for yourself when something doesn’t feel right is more important than we often realize. Here are five surprising signals your body might be sending you.
1. You feel short of breath doing things that used to feel easy.
“Heart disease reduces the ability of the heart to pump blood, which delivers oxygen and nutrients to the rest of the body,” says a Dr. If your heart is not pumping effectively, the lack of oxygen to different tissues can cause fatigue, muscle soreness, dizziness and difficulty breathing.
Getting winded after a tough workout is normal. Getting winded while talking, walking or lying down is worth paying attention to. Shortness of breath can happen when blood flow isn’t moving smoothly through the heart and lungs, almost like a traffic jam in your circulatory system.1 When plaque starts to build up, it narrows the blood vessels and slows down circulation, making the heart work overtime. That extra strain can cause fluid to back up in the lungs, leading to that breathless feeling, especially when lying flat. “Don’t ignore subtle changes,” encourages a Dr., “Your body is giving you important feedback. I recommend tracking symptoms, noting when they occur and speaking with a health care provider promptly.”
2. Your gums bleed or your oral health has taken a turn.
There’s a strong connection between gum disease and heart disease. Chronic inflammation in the mouth can spill over into the bloodstream, contributing to inflammation in the blood vessels. The bacteria that cause gum infections can enter the bloodstream and can lead to systemic inflammation that can damage blood vessels and increase the risk for cardiovascular events like heart attacks and strokes. “It’s also important to note that gum disease and heart issues often have some common risk factors, like unbalanced diet, diabetes and chronic stress,” shares a Dr. “Aside from good oral hygiene, foods high in vitamin C, antioxidants and omega-3 fatty acids can support healthy gums,” notes a Dr.
3. You’re dealing with swelling in your legs, ankles or feet.
If your socks are suddenly leaving deeper marks or your shoes feel tighter by the end of the day, it could be a sign of fluid buildup. “When the heart isn’t pumping effectively, fluid can start to pool, especially in the lower body,” says a Dr. The elevated pressure forces fluid out of blood vessels into surrounding tissues, especially the legs, ankles and feet. This can be a symptom you may write off as just from being on your feet all day, but it could be more than that. Taub-Dix notes that many women who have swollen ankles or puffy feet might attribute this fluid retention to eating salty foods or wearing tight shoes, but this may be a sign that something more might be brewing. It’s best to call a health care provider and set up an appointment to discuss these symptoms rather than waiting until something worse might occur.
4. You feel nauseous, lightheaded or dizzy.
Heart-related symptoms don’t always show up in ways that feel obviously connected to your heart. Some people, especially women, experience things like nausea, dizziness or a general uneasy feeling before more obvious symptoms show up. It can be vague, which might be easy to ignore, but unusual symptoms are often worth a closer look.
Research suggests that symptoms like dizziness and fatigue don’t often happen in isolation. In people with cardiovascular disease, higher stress levels have been linked to poorer sleep, with fatigue and dizziness acting as key middle players, essentially creating a loop where feeling off can both stem from and contribute to overall strain on the body. “My general recommendation is always to see their provider, get an EKG and basic blood work. Make sure that risk assessment calculations are being done and be forthcoming about family history so that your provider can assess risk properly,” says a Dr. Harris-Pincus also recommends that it’s important to stay hydrated, manage blood sugar, monitor BP and eat potassium rich foods.
5. You feel pain that isn’t in your chest.
Heart-related pain can show up in your jaw, neck, back, shoulders and even arms. This type of pain doesn’t always feel like a sharp pain; it can be more of a dull ache, pressure or discomfort. In some cases, this type of discomfort happens because the nerves that carry pain signals from the heart overlap with other areas of the body, essentially redirecting the sensation elsewhere. “Because women generally have a smaller heart and blood vessels than men, which are more prone to damage and blockage, women are more likely to have microvascular disease in the heart and peripheral arteries. This shows up as more subtle symptoms than the typical angina [chest pain] associated with blockages in the larger coronary arteries,” says a Dr.
A Dr., urges, “Any persistent or unusual symptoms should be evaluated by a qualified health care professional, especially if they represent a change from baseline. Women are more likely to present with atypical symptoms (such as fatigue, nausea, back or jaw pain) rather than chest pain, so subtle changes should not be dismissed.” If this type of pain is new, unexplained or happening alongside other symptoms like shortness of breath, nausea or fatigue, it’s worth getting checked out sooner rather than later. It’s always better to rule something out than to ignore a signal your body is trying to send.
Other Tips for Supporting Heart Health
- Be mindful of electrolytes: The American Heart Association recommends that the average American should limit sodium intake to no more than 2,300 milligrams per day. “Trendy electrolyte brands contain upwards of 500 to 1,000 mg of sodium. Unless you are very active and need to replenish sodium lost through sweat, you do not need a daily electrolyte supplement. Consider flavoring your water with citrus instead of an electrolyte packet to support your hydration instead,” says a Dr.
- Prioritize regular checkups: “Have your blood lipid levels checked one to two times per year. If there is a family history of heart disease, I would request having lipoprotein(a) measured in addition to a standard blood lipid panel,” says a Dr. Katz also notes, “Newer recommendations emphasize earlier identification of lipid abnormalities, use of advanced markers like lipoprotein(a) and apolipoprotein B in select patients and consideration of coronary artery calcium (CAC) scoring to detect subclinical atherosclerosis and refine risk assessment.” 10 This reflects a broader shift toward detecting risk earlier before symptoms develop and intervening proactively.
- Practice healthy sleep hygiene: “Aside from ensuring that you see a provider and advocate for evaluation, I always recommend that you prioritize your sleep. So many of us don’t get the recommended seven hours of sleep, and not sleeping well can have a downstream inflammatory effect on your body,” notes Jayman-Aristide.
- Eat a balanced diet: Dietary patterns like DASH (Dietary Approaches to Stop Hypertension) and the Mediterranean diet are evidence-based, sustainable and nutritionally balanced ways to support heart health for the long term. “Focus on fiber-rich plant foods like fruit, veggies, pulses (such as lentils, chickpeas, beans and peas), nuts, seeds and whole grains. Include lean proteins from seafood, poultry, soy, lean cuts of meat and low- or nonfat dairy,” recommends Harris-Pincus.
- Focus on small ways to increase your daily movement: Current guidelines from the AHA recommend at least 150 minutes per week of moderate-intensity activity or 75 minutes of vigorous activity, plus muscle-strengthening exercise at least two days per week.11 Start with what feels approachable to you by prioritizing things you can easily incorporate into your daily routine. “Try parking farther from the store to get in more steps, or take the stairs,” adds a Dr. Smolen notes that these small changes can add up over time to big heart-health benefits.
- Reduce the time you spend sitting down: “Prolonged sitting is now recognized as an independent cardiovascular risk factor, even in otherwise-active individuals,” notes Katz.12 To help you stay consistent, try setting an alert on your phone or in your calendar to get up each hour for five to 10 minutes to stretch and move around.
Our Expert Take
Heart disease doesn’t always announce itself loudly; sometimes it whispers. While any of these symptoms on their own don’t automatically mean something serious is going on, patterns over time matter. If something feels off or different from your norm, it’s always worth checking in with a health care provider. When it comes to your heart health, catching things early can make all the difference.