What Women Need to Know About Heart Disease

The media is a powerful entity.  And when it comes to its portrayal of heart disease, the danger in that power is especially evident.  We are left to assume that heart disease is a man’s disease.  That men die from heart attacks.  That men need to watch their cholesterol, lower their high blood pressures, and start exercise programs.    While this information is certainly true, we are getting only part of the story.  Who is missing?

Women.  Lots and lots of women.

Young and old, across ethnic groups and body types, heart disease is very much a woman’s disease.  Nearly a quarter of women die from coronary heart disease (other sources say this number is closer to one third) and some heart conditions are more common in women than in men.  Special circumstances can put women more at risk for a heart attack, too.  Not to mention that women don’t necessarily experience the “typical” signs of heart attack.  For these reasons, attention must be paid to this number one killer of both men and women in the United States.

Despite the differences between men and women when it comes to coronary heart disease (CHD), how CHD develops is the same in both genders.  The coronary arteries narrow when cholesterol and fat accumulate; the condition that results from this buildup, or plaque, is called atherosclerosis.  When this happens, blood carrying oxygen to nourish the heart muscle can’t reach the heart muscle effectively, and then chest pain (angina) occurs.  But if a plaque breaks open and creates further blockage of a coronary artery, a new problem arises:  oxygen cannot reach the heart muscle at all and muscle fibers die.  This is what happens during a heart attack.  And what’s more is coronary heart disease can also cause heart failure, abnormal heart rhythms and sudden death.

It’s a scary prospect.

Due to the heft of this topic, in a later post I’ll discuss risk factors for CHD and what women (and men) can do about them.  But first, let’s dispel some myths about women and heart disease:

Heart attacks only happen in elderly men.  It’s shocking that more women than men are affected by heart disease, and that almost one in three women die from CHD.  Gender-specific lifestyle factors can increase the risk of heart disease, too.  Smoking while taking birth control pills (yes, really), can up a woman’s risk by 20%.

I can’t do anything about my family’s health history.  True.  But women (and men) can alter risky lifestyle choices.

Ok, but I exercise to stay healthy.  Exercise may actually prove to be a “miracle” drug, as new studies emerge that show interesting health-related benefits beyond those of the heart.  However, if a person’s diet is poor, or she smokes, these risks can negate the benefits of regular exercise.

I don’t have any symptoms of heart disease.  We understand the herald signs of a heart attack to be chest pain that extends down the left arm, and that these symptoms occur with exercise or stress.  However, these are symptoms typically experienced by men, not necessarily women.  What’s scarier is that 65% of women who die suddenly from heart disease don’t have symptoms at all.

So what signs and symptoms of a heart attack are more common in women?  Some will surprise you:

Jaw pain.  While women can develop the familiar chest pain with angina, jaw pain may occur instead, and in addition,

Back pain, or even a stomachache.

Chest discomfort.  A typical description of chest pain is a “crushing” sensation with pain going down the left arm; but women can experience a fullness or pressure, like someone is “sitting on my chest.”

The sweats.  Not like hot flashes, but sweats that feels stress- or panic-related; this can go hand-in-hand with difficulty breathing.

Fatigue.  Women often feel tired, everyday.  We work hard, we parent, we have household and outside-the-household responsibilities.  But if fatigue keeps you from doing the usual activities of daily living, like lifting a load of laundry, or even standing to take a shower, this could herald a heart attack.

Any pain located above the waist.  As one source I consulted cut to the chase:  any pain that comes and goes (day or night), or appears gradually or suddenly, and is anywhere above the waist, needs to be evaluated immediately by a healthcare provider.

There are also lesser-known heart conditions that affect women more frequently than men:

♥Microvascular disease (MVD), otherwise known as Syndrome X.  As the name suggests, this condition affects the smaller arteries that supply the heart with blood and oxygen.  As with CHD, plaque builds up and can lead to blockage of these vessels, causing a heart attack.  It may affect more women after menopause, due to the drop in estrogen production.  MVD is a true silent killer;  clinical tests that look for narrowing of the larger coronary arteries cannot visualize these smaller vessels.

♥Broken Heart Syndrome.  A recently identified condition, this heart ailment also affects more women than men.  The symptoms mimic a heart attack but are caused by severe emotional stress and lead to temporary heart failure.  This syndrome usual occurs in healthy women with no evidence of CHD, but the good news is most women completely recover.

So what can women do to decrease their risk of heart disease?  Next week, I’ll explore this topic.

If you are interested in learning more, here are my sources for this article and their links:

goredforwomen.org  A note about this site.  It is awesome.  For accessible information about women and heart disease, take a look.  You’ll get lost in the site for its comprehensive easy-to-read style and organization.

nhlbi.nih.gov

webmd.com

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