When we think of heart attacks, we may think of a scene from a movie of an overweight man eating a steak in a fancy restaurant, then suddenly clutching his chest in pain and dramatically falling to the floor while his bejeweled wife screams for someone to call 911.

While this Hollywood version of a heart attack can happen for men, it typically doesn’t happen this way when women have a heart attack.

Women’s heart attacks don’t normally come with the expected high drama.

Women and heart attacks

Believe it or not, a greater percentage of women than men die from heart attacks in the United States. And while women should be actively examining themselves for lumps in their breasts and getting regular physicals, heart conditions actually kill more U.S. women than all cancers combined.

Until recently, some doctors believed that women didn’t have heart attacks. Because of this assumption, research studies typically observed all-male participants for heart conditions.

Martha Weinman Lear, author of Heartsounds, wrote in The New York Times about the history of women and heart disease: “Men with abnormal [heart] test results were treated far more aggressively than women with the same results. Women reporting the same symptoms as men were at least twice as likely to receive—no surprise here—a psychiatric diagnosis.”

The misinformed perception of women and heart attacks continued into the '90s. In 1996, a national survey found that two-thirds of doctors were unaware that different symptoms of a heart attack occurred in the two sexes.

This gender bias improved in 2001, when a study conducted by the United States Institute of Medicine analyzed data, discovered the bias, and pressed for change. And yet women still remain only 24 percent of participants in heart-related medical studies.

Women's heart attack symptoms

A woman often receives prior warning with symptoms like extreme fatigue and insomnia, whereas men typically have no such alert. Another difference between genders is the amount of chest pressure felt. Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center, explains, “Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure.”

But, isn’t chest pressure the telltale symptom of a heart attack? How on earth are women to know if the medical catastrophe is really happening?

Women can experience heart attack symptoms from their nose to their pelvis, including the jaw, neck, throat, back, shoulders, arms, and diaphragm. They can experience shortness of breath, dizziness, lightheadedness, nausea, chills, and pressure or pain in the lower chest or upper abdomen. Experiencing two or more of these symptoms simultaneously is a good indicator of a heart attack.

But many women blame these symptoms on the flu, acid reflux, or normal aging and thus don’t get treated, leading to a greater potential for worsened heart conditions and ultimately, death. That’s why it’s imperative to call your doctor if you are experiencing any of these possible heart attack symptoms. Even if does turn out to be acid reflux, you would much rather be considered a hypochondriac than ignore your heart health.

All in all, there are more female deaths from heart attacks in the U.S. largely because women discount their symptoms and don’t move forward with the proper treatment. You can break this trend by talking to your doctor about your heart health and being prepared.