What is the most common symptom of myocardial infarction in women that may differ from men's presentation?

Women, elderly clients, and people with diabetes may present with atypical MI symptoms that delay diagnosis. Classic 'textbook' MI: crushing substernal chest pain radiating to left arm or jaw, diaphoresis, nausea, sense of impending doom. Atypical presentations more common in women, elderly, diabetic clients: unusual fatigue (often weeks before the event); shortness of breath as the primary or only symptom; indigestion or epigastric pain often mistaken for GI issues; nausea and vomiting; back, jaw, or neck pain; lightheadedness or syncope; pain in shoulders or arms; sleep disturbances. Women frequently delay seeking care because their symptoms are dismissed or attributed to anxiety. Nurses must maintain high index of suspicion for cardiac etiology when women, elderly, or diabetic clients present with vague or atypical symptoms. Diabetes can blunt typical pain because of neuropathy — silent MI is common in diabetic clients.