With BP at 130/70 mmHG, pulse beat at 86, ECG normal, 37-year-old woman had a silent heart attack: What are subtle symptoms?

By Admin

17 Feb, 2026

A Routine OPD Visit That Turned Alarming

When 37-year-old Gayathri walked into a gastro OPD, she believed she was dealing with simple digestive discomfort. She had experienced heartburn that subsided after drinking water, a feeling of fullness in the stomach that came and went, and a dull back discomfort she assumed was gas buildup.

These symptoms were new, but mild. She attributed them to mid-age body changes.

As part of a routine evaluation, the doctor ordered an ECG and a troponin test   a blood test that detects proteins released during heart muscle damage.

Her ECG was normal.
Her blood pressure was 130/70 mmHg (close to her usual 120/80 mmHg).
Her pulse rate was 86.

Nothing appeared alarming.

But her troponin levels told a different story   she had already suffered a heart attack.

The Hidden Blockage in the Heart

Further investigations revealed a blockage in the Left Anterior Descending (LAD) artery   the largest supplier of oxygen-rich blood to the heart’s pumping chambers.

The blockage was cleared with a stent.

On deeper medical evaluation, she was diagnosed with polycystic ovary syndrome (PCOS)   a condition often associated with:

• Insulin resistance
  
  

• Hypertension
  
  

• High cholesterol
  
  

• Obesity
  
  

All of these significantly increase heart disease risk.

Other potent triggers include stress, smoking, and alcohol consumption.

No Classic Symptoms   That’s the Danger

Gayathri had:

• No crushing chest pain
  
  

• No breathlessness
  
  

• No jaw or arm pain
  
  

• No nausea or vomiting
  
  

• No anxiety or sense of doom
  
  

These are the classic signs most people associate with a heart attack.

But women often don’t present this way.

Heart Attack Risk in Women: A Reality Check

Cardiovascular disease is the leading cause of death among women globally   surpassing even breast cancer.

In India:

• One in five women between 15 and 49 years has untreated hypertension.
  
  

• Many women do not undergo evaluation until after their 40s.
  
  

• A 30-year-old woman with diabetes is at higher risk of a heart attack than a 30-year-old man with the same condition.
  
  

Although estrogen offers some protection before menopause, it is not absolute   especially when high-risk factors and unhealthy lifestyle behaviors are present.

Compounding the issue, most heart research historically focused on men, their triggers, and their symptoms   making women’s presentations less recognized.

Subtle Symptoms of Heart Attack in Women

Women often experience atypical and easily ignored signs.

1. Unusual Fatigue

Sudden exhaustion never experienced before   even after minimal activity.
Often dismissed as stress or lack of sleep.

2. Shortness of Breath

With or without chest discomfort.

3. Dull Pain in Jaw, Neck, or Back

Often mistaken for muscle strain or tension.

4. Abdominal Discomfort or Fullness

May feel like gastric issues or acidity.

5. Sudden Sweating or Hot Flash

Especially if it occurs for the first time without explanation.

6. New, Unfamiliar Symptoms

Any discomfort that feels different from usual body signals.

This is why heart attacks in women are often labeled “silent.”

They are not truly silent   they whisper instead of shout.

Why Heart Attacks in Women Can Turn Serious

Heart blockages develop differently in men and women.

In Men:

Most heart attacks occur due to plaque rupture   when fatty deposits break open and a clot forms around the tear.

In Women:

More commonly due to plaque erosion   where the surface of the plaque gets damaged and platelets gradually form clots.

Because plaque erosion causes milder symptoms initially, it can go unnoticed   but if untreated, it can progress into a major heart attack.

Young women typically have higher estrogen levels, which may influence plaque composition and increase susceptibility to erosion.

Smokers and drinkers are especially vulnerable.

Prevention: The Power of Early Screening

Heart disease in women remains:

• Under-recognized
  
  

• Underdiagnosed
  
  

• Often diagnosed late
  
  

What Women Should Do:

In Your 20s:

• Regular blood tests
  
  

• Monitor blood sugar
  
  

• Check cholesterol levels
  
  

• Track blood pressure
  
  

In Your 30s:

If you have a family history:

• ECG
  
  

• Echocardiogram
  
  

• Stress test
  
  

• Calcium scoring
  
  

In Your 40s:

Even without family history:

• Comprehensive cardiac evaluation
  
  

A Simple Rule to Remember

If you experience a symptom you have never had before   investigate it.

Do not automatically blame:

• Gastric issues
  
  

• Muscle catch
  
  

• Hormonal fluctuations
  
  

• Stress
  
  

Not every new symptom is a heart attack.
But every new symptom deserves attention.

The Takeaway

Gayathri’s case is a wake-up call.

Normal blood pressure.
Normal pulse.
Normal ECG.

Yet, a silent heart attack had already occurred.

Women must stop taking heart health for granted.

Prioritize:

• Regular screenings
  
  

• Lifestyle correction
  
  

• Stress management
  
  

• Early evaluation of unusual symptoms
  
  

Because when it comes to heart disease in women   silence can be dangerous.