4 women were told they had stress, anxiety or fatigue. It turned out to be a serious heart issue.

• Symptoms like anxiety and fatigue don't normally mean that there are serious heart issues.
• But Insider spoke with four women who had serious cardiac events after these symptoms were ignored.
• Many of them are now advocates and want women to listen to their bodies more.

Most people experience stress and fatigue, and it's usually no big deal. In the majority of cases, it is more likely to mean that you need a better night's sleep, not that there is something wrong with your heart. 

But in some rare cases, these subtle symptoms can be the first warning signs that something is very wrong. And they can be easy to ignore amid the stress of everyday life including work, children, caring for other family members, and more. Insider has reported before about medical gaslighting, and how doctors can make people doubt their own symptoms. Sometimes it's easy for us to doubt our own symptoms as well.

Recently, Insider spoke with four women who experienced severe cardiac events including heart attacks and heart failure with very few warning signs. All of these women were successful, high-achieving professionals, and many of them dismissed their early symptoms as job-related stress or anxiety. Now, they want other women to know the warning signs and advocate for their health. 

Here are their stories:

A pediatrician thought she had stress-induced acid reflux — it was a heart attack 

In July 2021, Jessica Cohn had horrible acid reflux — or so she thought.

Cohn, now 37, said she was caring for her two young kids and working as a pediatrician when she started experiencing an occasional pain that radiated from her chest up to her throat, usually at night. With a six-month-old and a three-year old at home, she told Insider it was easy to chalk her symptoms up to stress.

After a few days, Cohn went to the hospital when the pain got severe. But even though she is a doctor herself, she assumed her symptoms were normal for a stressed-out new mom. The other doctors also dismissed her symptoms as anxiety. 

Finally, doctors tested Cohn's for troponin, a type of protein that shows up in the blood when the heart has been damaged. She said she was "absolutely shocked" when the test came back positive — she had been having a heart attack. 

"Taking a moment to be aware of your own health, even when you're taking care of everyone else, is something I learned," she told Insider.

A yoga teacher who thought her pain was allergies and anxiety had 3 heart attacks 

Dina Pinelli thought she was "the epitome of health," until she had three heart attacks in June 2020.

The yoga teacher, who was 45 years old at the time, told Insider that her whole family made an effort to eat mostly organic, unprocessed foods after her father suffered a massive heart attack decades prior. She also meditated daily and exercised often.

But midway through her attempt to walk 5k every day for a week, she found herself draped over the treadmill with chest pain and shortness of breath. She later learned that she had experienced one of multiple heart attacks — and she would have a second heart attack less than a week later. 

"I was so angry at myself for not being able to do it that I was pushing it," she told Insider. "I tried all of this positive self-talk that actually could have killed me."

It was only right before her third heart attack that Pinelli decided to listen to her body and went back to the doctor for more tests. Her EKG and troponin levels —both measures of heart function — came back abnormal, and she had her third heart attack at the hospital. 

After switching to a female cardiologist and trying new medication, Pinelli can work out again — but she told Insider she's a much better advocate for her own health. 

A "go-getter" dismissed her symptoms as anxiety and menopause, but she actually needed a heart transplant 

When Ann Ramirez Duda woke up in the middle of the night struggling to breathe, she thought she must be having a panic attack.

It was the summer of 2018, and Duda, then 48, was taking care of her ailing father at home. She told Insider she assumed her shortness of breath was caused by anxiety and exacerbated by the wildfires that were raging in California at the time. 

"It was the fires, the menopause; it's the kids, or too much work," she said. "Never in my million years did I ever think it was my heart."

After postponing two doctor's appointments, Duda finally saw her primary care doctor in October 2018. She was diagnosed with congestive heart failure, which was causing her to feel breathless and exhausted. Medication and a new diet would help her manage the condition, but eventually, she would need a new heart.

For two years, Dudas managed her condition with medication, a low-sodium diet, and closely monitoring her fluid intake. But when her health took a nosedive in 2020, it was time for a heart transplant.

While awaiting the transplant, doctors also found a golf ball-sized brain tumor in her head. "The discussion became, do we take out the brain tumor first and then do a heart transplant, or do we do a heart transplant first and then do a brain surgery?" she told Insider. 

The doctors decided to remove the tumor first, and then do the heart transplant. Now, she said, she's determined to prove that the new heart she was given won't go to waste. 

A young professional dismissed her symptoms as job stress. She almost died days later. 

Brittany Williams was working in an accounting firm in Tallahassee, Florida, at age 24 when she felt the left side of her body go numb. She Googled her symptoms, and learned that stroke, heart attack, and cardiac arrest were possible culprits. "I started to panic," Williams, now 32, told Insider. 

But when she told her boss how she was feeling and what it could mean, her boss told Williams she was overreacting — and Williams agreed. 

"I was like, 'You're right. I'm only 24. I'm running five miles every day, eating extremely healthy, living a healthy lifestyle,'" Williams said. So she brushed it off as stress from tax season and working a retail job on the side.  

But a few days later, while on a family trip to New York City, Williams collapsed at a Times Square bar. She'd suffered a cardiac arrest due to an undiagnosed heart condition. She credits bystanders and an automated external defibrillator, or AED, with her survival.  

"I was in disbelief," Williams said. "I just thought heart disease happened to the elderly or heavy smokers and heavy drinkers, not young adult athletes like me. I just never in a million years would picture myself going into cardiac arrest." 

Williams was diagnosed with long QT syndrome, a heart signaling disorder that causes "fast, chaotic heartbeats," according to the Mayo Clinic. The National Organization for Rare Diseases estimates that about 1 in 2,000 people are born with the condition. 

Now she has an internal defibrillator, which monitors her heartbeat and shocks it back into a normal rhythm in the case of another cardiac event. She also wants people to learn how to recognize the signs of cardiac arrest and to perform CPR if necessary.