Don't ignore the gasp: Why breathlessness is a heart alert for women

Heart disease in women often appears without a crushing chest pain. Experts say shortness of breath is frequently the earliest warning sign and should never be dismissed as stress or fatigue

Shortness of breath is often brushed aside as stress, ageing or lack of fitness, yet it can be one of the earliest warning signs of heart disease in women. While many people still associate heart problems with crushing chest pain, women frequently experience subtler symptoms and breathlessness may appear long before any pain does. Recognising this difference can be lifesaving.

 

Dr Navida Batra, interventional cardiologist at Metro Hospital and Cancer Institute, Metro Hospital, New Delhi, explains that heart symptoms in women often do not follow the textbook pattern and are often overlooked.

 

Why breathlessness can be an early red flag

 

“Shortness of breath can signal reduced blood flow or impaired heart pumping before chest pain appears,” says Dr Batra. She adds that women are more likely to develop small-vessel or diffuse coronary disease, which limits oxygen delivery without causing the classic heavy pressure in the chest.

 

 

As a result, a woman who feels unusually breathless while climbing stairs or doing routine household work may actually be experiencing an early sign of heart dysfunction. As there is no dramatic chest pain, the symptom can be ignored until the condition worsens.

 

How women’s symptoms differ from men’s

 

For decades, heart disease models were largely based on men’s symptoms, and this has led to gaps in recognising how women present differently. Dr Batra notes that women are more likely to report:

 

• Unexplained fatigue
• Nausea or indigestion-like discomfort
• Back or jaw pain
• Lightheadedness
• Shortness of breath

 

“These symptoms are usually less severe, intermittent, or attributed to stress, indigestion, or anxiety,” she explains. As a result, many women delay seeking help and some are misdiagnosed in the early stages.

 

Which heart conditions are linked to shortness of breath?

 

Breathlessness in women can be linked to several underlying cardiac problems. These include:

 

• Heart failure
• Coronary artery disease
• Coronary microvascular disease
• Valve disorders
• Cardiomyopathies - disease of heart muscles

 

In these conditions, the heart cannot pump or relax properly and this leads to fluid build-up or reduced oxygen supply. Consequently, women may feel breathless during exertion and sometimes even at rest.

 

What risk factors should women not ignore?

 

Certain life stages and medical conditions increase vulnerability. Dr Batra points out that menopause reduces the protective effect of oestrogen and makes blood vessels stiffer. Diabetes and hypertension raise heart disease risk more sharply in women than in men, while pregnancy complications such as preeclampsia or gestational diabetes can predict future cardiovascular problems.

 

Autoimmune diseases, which are more common in women, also increase inflammation and blood vessel damage.

 

When should women seek urgent help?

 

It can be difficult to distinguish cardiac breathlessness from anxiety or lung issues, yet some patterns stand out. Breathlessness linked to heart disease typically worsens with physical activity or when lying flat and may be accompanied by leg swelling, fatigue or chest discomfort.

 

“Call for immediate care if shortness of breath is accompanied by chest discomfort, passing out, palpitations, sweating, or radiating pain to the jaw or arm,” advises Dr Batra.

 

For early detection, she recommends regular blood pressure and cholesterol checks, blood sugar testing, ECG (Electrocardiogram), echocardiogram and stress testing, especially for women with known risk factors.

 

Heart disease remains one of the leading causes of death among women, yet awareness is still catching up. Listening to your body and acting on persistent breathlessness could make all the difference.

 

What can help women self-manage mild breathlessness?

 

While medical evaluation is essential if symptoms persist or worsen, a few simple strategies can help manage mild breathlessness day to day:

 

• Find a comfortable position, such as sitting upright in a chair or being propped up with pillows in bed while resting or sleeping, as this can ease pressure on the lungs
• Practise slow, relaxed breathing techniques, focusing on steady breaths in and out to avoid panic
• Plan daily activities carefully and build in short breaks so your body has time to rest and recover
• Stay as active as you safely can, because light movements also help maintain stamina
• Open a window or use a fan to improve air circulation, which can create a sensation of easier breathing

 

Seek support from loved ones or healthcare professionals if you feel overwhelmed, as managing symptoms is easier with the right guidance.     

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This report is for informational purposes only and is not a substitute for professional medical advice.