A study published recently in the Journal of the American Medical Association documents that younger women (those under 55 years of age) are much less likely to experience chest pain with their heart attacks than are older women or men. Worse, their mortality rate with their heart attacks are significantly higher than for older women or men.
The higher death rates may be explained, at least in part, by the fact that it probably takes these women longer to realize (given the lack of chest pain) that they might be having a serious problem, and therefore longer to get to medical help. When you are having a heart attack, minutes count.
While younger women may experience chest pain less frequently with heart attacks, very few of them have no symptoms at all. Most will have nausea, vomiting or indigestion, disturbing shortness of breath, pain outside of the chest area, or simply sudden and extreme fatigue.
It is important for women - of any age - to understand that they are less likely to have "typical" symptoms if they have a heart attack, and, especially if they are at increased risk for cardiovascular disease, they must be alert to any new, unexplained, disturbing symptoms.
Canto J G, Rogers W J, Goldberg R J et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA 2012; 307:813-822.