Q:  I’m a healthy, active 45-year-old mom, but there’s a history of heart disease on both sides of my family—and as I get older, this worries me. Recently a friend told me that heart attacks in women can sometimes go undetected. What symptoms should I pay attention to?

A:  Symptoms of heart disease can vary from person to person. Stable heart disease can present with chest pain or pressure, shortness of breath or simply fatigue. I often have patients who say,” I feel like I just got older this summer.” Most often, these symptoms occur with activity and get better with rest.

Heart attacks often don’t look the same in men and women. The signs can be more subtle for women, so if you have a health history like yours it’s especially important to be aware.

Chest pain or discomfort is the most common symptom for both women and men. The pain may last a few minutes or come and go. The pain may be severe or may feel like a pressure or discomfort; sometimes people describe it as heartburn.  

Women are more likely than men to have other heart attack signs, including shortness of breath with or without chest pain; nausea or vomiting; lightheadedness; back, shoulder, arm or jaw pain; and unexplained fatigue that can drag on for days.

And yes, some studies have found that women are at higher risk for what we call “silent” heart attacks, with symptoms so mild they go unnoticed or are dismissed as anxiety. Silent heart attacks can be as dangerous as more obvious ones—left untreated, they can cause scarring and permanent damage, raising the risk of other heart problems. So don’t be too quick to dismiss shortness of breath or lightheadedness as just anxiety. And make sure you tell medical professionals that you think you might be having a heart attack, not an anxiety attack.

Quick treatment can restore blood flow to the heart and help prevent damage. So be aware of these warning signs for both yourself and others. If there’s even a slight chance you could be having a heart attack, don’t wait. Call 911 and get to a hospital to give your heart the best chance!

Prevention is just as important as treatment of heart disease. Make sure to check your blood pressure and cholesterol and take your medications as prescribed by your primary care provider. Exercise, a good sleep routine and a healthy diet (incorporating lean protein, vegetables and healthy fats while avoiding processed foods) also go a long way in keeping your heart healthy.

Dr. Banerjee is an interventional cardiologist at PeaceHealth’s Oregon Heart & Vascular Institute. Learn more at peacehealth.org/ohvi