Are Heart Attacks Different in Women?

Men have more heart attacks than women, yet women are more likely to die from a first heart attack. Why is that?

Unfortunately, heart disease is still often thought of as a man’s disease, even though women account for half of all cardiovascular deaths. And heart disease kills six times as many women as breast cancer does every year. But women are less likely to think about their heart health, or watch for signs that might indicate heart disease. And women often experience very different symptoms than men when having a heart attack. As a result, many delay seeking treatment until it’s too late.  Changing these trends starts with understanding some important differences between men and women when it comes to heart health:

• For both women and men risk factors include family history, diabetes, high blood pressure or cholesterol, obesity, lack of exercise and smoking. But endometriosis, polycystic ovary disease, and gestational diabetes all increase the risk of coronary artery disease - which is the leading cause of heart attack – and they only affect women. Studies have also shown that stress, a risk factor for both sexes, takes a greater toll on women’s hearts.
• Women develop heart disease about 10 years later than men. Estrogen helps protect heart health during the younger years, but when levels drop after menopause, women develop heart disease at higher rates. That’s why it’s important to get yearly screenings and monitor blood pressure, blood sugar, and cholesterol levels, particularly after age 50.
• After a heart attack, women have a higher risk of developing a blood clot that could cause another heart attack. But women are less likely to receive blood thinners or other medications that could help prevent clots from forming.

Developing heart healthy habits, being aware of risk factors, and getting regular tests and screenings can help prevent or manage heart disease. But nearly 65% of women who die from heart attacks have no previous symptoms. In the weeks leading up to a heart attack, women frequently experience unusual fatigue, anxiety, indigestion or sleep issues that may signal a looming heart attack, but are all too often ignored. And during a heart attack, chest pain is more likely to feel like pressure, heaviness, or tightness rather than the crushing and intense pain men often feel. However, about 50% of women don’t have any chest pain during a heart attack, so it’s important to know the other unique symptoms women may experience, including:

• Pain in one or both arms
• Upper back, shoulder, neck or jaw pain
• Abdominal discomfort
• Dizziness or fainting
• Nausea or vomiting
• Shortness of breath
• Extreme fatigue

If you think you or a loved one may be having a heart attack, call 911 immediately. Women tend to wait to seek treatment, or downplay their symptoms and therefore don’t get the treatment they need. Getting proper care immediately can minimize heart damage and help prevent further complications.

This article first appeared in the February 2019 edition of the HealthPerks newsletter.