According to the CDC, more than 800,000 people have a heart attack every year in the United States, and heart disease–a precursor to many of those heart attacks–is the leading cause of death across all genders, ethnicities, and racial groups. However, women are more than twice as likely to die after a heart attack than men, and they are more likely to have a second heart attack in the 5-6 years after their first one. From unique risk factors that are rarely mentioned to underrepresentation in medical research and misdiagnosis from their providers, women are often left out of the heart attack conversation and experience delays in care that could be deadly.
Dr. Randy Lombardo of Advanced Cardiovascular Specialists has seen this discrepancy over and over throughout his 40 years as a.cardiovascular disease specialist. “It is imperative that women educate and advocate for themselves to learn their chances of having a heart attack and take the necessary steps to mitigate the risk.”
For more than 65 years, Advanced Cardiovascular Specialists has led Southeast Texas in advanced cardiology care and services. They pioneered life-changing procedures including cardiac catheterization, pacemaker implantation, and angioplasty, and they remain at the forefront of innovation and advanced treatment modalities. Advanced Cardiovascular Specialists provide comprehensive cardiovascular care, treatment, diagnostic, and prevention services designed to help you–and your heart–stay as healthy as possible.
What is a heart attack?
A heart attack, or myocardial infarction, occurs when the blood flow to the heart is either blocked or greatly reduced. The lack of blood flow then causes the tissue in the heart muscle to die.
The blockages are usually caused by cholesterol and fatty deposits in the coronary (heart) arteries that build up over time in a process called atherosclerosis. This buildup can also lead to a condition called coronary artery disease, the most common type of heart disease and the leading cause of heart attacks. Because there are not many outward signs of this slow and gradual build up, heart disease–including coronary artery disease–is often called the silent killer.
Women’s Risk Factors for Heart Attack
Heart disease is the leading cause of death in women, responsible for the deaths of over 300,000 women in the U.S. alone. While not all women who have heart disease will suffer from a heart attack, the risk factors for heart attacks are often the same as those for heart disease. However, risk factors for heart disease affect women more acutely–creating higher risk than for men–and women are also more likely than men to have heart attacks that are not caused by heart disease, making it even more difficult for providers to make the proper diagnosis.
Common risk factors that increase the chances of a woman having a heart attack are:
- Obesity
- Tobacco Use
- High Blood Pressure
- Stress
- Family History
- Autoimmune Condition
- Lack of Exercise
- Poor diet
Women are also subject to unique risk factors that can impact their heart health, including:
- Menopause and perimenopause, including early menopause or a period before age 11
- History of preeclampsia (high blood pressure during pregnancy) or gestational diabetes
- Preterm delivery or delivery of a low or high birth weight infant
- Pregnancy. While not common, heart attacks are possible during and soon after delivery.
- Age. Women tend to be older when they have a first heart attack, which can contribute to the type and severity of damage.
Higher levels of stress, anxiety, and depression can also increase a woman’s risk of developing heart disease and having a heart attack.
Common Heart Attack Symptoms in Men vs. Women
Heart attacks can occur suddenly, but many times, there are warning signs and symptoms hours, days, or weeks beforehand that can vary from person to person. Some people may experience mild to severe symptoms, while others may not experience any at all.
Men typically experience:
- Chest pain
- Radiating pain in the left arm
- Shortness of breath
- Nausea
- Vomiting
- Dizziness
- Sweating
While women can experience these same symptoms, there are also a host of other indicators that could signal a heart attack. However, because of the historical emphasis on the signs of a heart attack in men, many women do not recognize symptoms such as:
- Intermittent pain rather than constant pain
- Uncomfortable squeezing feelings or pressure that comes and goes rather than the chest pain that is more common in men
- Back pain or jaw pain
- Indigestion or nausea
- Unusual, sudden, and/or extreme fatigue
- Brief or sharp pain in the neck or arm
- Sudden cardiac arrest
- Clamminess
- Lightheadedness
- Sweating
The reasons for these differences in symptoms can be attributed to a variety of factors, including hormones and physical differences in the coronary arteries. For example, women in the later stages of pregnancy and the few months following delivery can show signs of heart disease, as changing hormones affect the entire body and sometimes specifically the arteries. Declining estrogen levels before, during, and after menopause can reduce the amount of protection the heart has to damage, while pregnancy stress, weight gain, or unhealthy eating during pregnancy may also contribute to poor heart health.
In terms of arteries, the size of women’s blood vessels are usually distinctly smaller than men’s and can affect blood flow to the heart. Blockages in women are more likely to be found in the smaller arteries rather than larger arteries, where buildup is less noticeable, causes less intenses pain, and results in a slower diagnosis.
What Women Should Do in the Event of a Heart Attack
If you think you may be having a heart attack and/or begin to experience any of the symptoms listed, get help right away and follow these steps:
- Call 911 for emergency medical help. If there is no access to emergency medical services, have someone drive you to the nearest hospital. Driving yourself to the hospital is a last resort.
- Take nitroglycerin (if prescribed) as instructed until emergency help arrives.
- Take aspirin (if recommended) to reduce heart damage and prevent blood clotting.
Statistics show that women are two to three times more likely than men to experience adverse health outcomes after a heart attack, so even after a heart attack, women should seek additional monitoring and medical check-ins, referral to cardiac rehabilitation, and strict control of diabetes, blood pressure, and cholesterol levels to reduce their risk of future heart attacks and lasting damage.
The Danger of Misdiagnosing and Delaying Treatment for Heart Attacks in Women
Urgent and early treatment during a cardiovascular event like a heart attack can often mean the difference between life and death because each minute after a heart attack more heart tissue suffers injury or dies, weakening the heart muscle and causing lasting, long-term damage. However, since symptoms of a heart attack in women are typically more subtle than those in men, they can be easy to blow off or ignore, resulting in a misdiagnosis from a doctor or delayed treatment.
Even if a heart attack isn’t fatal for a woman, it can still make a significant impact on her overall health; although women typically have a lower risk of cardiovascular events than men, the damage is greater when they do have a heart attack, they experience worse short- and long-term outcomes, and they are more likely to develop future events and dying from cardiovascular disease.
Direct correlations are unclear, but this could be because women are typically older when they experience a heart attack–nearly 70, as opposed to the average age of 66 for men–or because women tend to have more underlying health conditions or risk factors that go undiagnosed or untreated, increasing the severity of the damage caused by a heart attack. It could also be because women experience a decrease in estrogen during and after menopause, a hormone that provides a certain degree of heart health protection.
Because many of the possible symptoms of a heart attack in women can be associated with conditions seemingly unrelated to a heart attack–anything from a stomach bug or heartburn to stress and anxiety–it’s important for women to be familiar with all of the signs of a heart attack and to pay attention to their “gut feeling” if they feel that something is wrong. And if they feel their physician isn’t taking their symptoms seriously, says Dr. Lombardo, “they need to insist on receiving further testing and a second opinion.”
He also has additional advice for women. “Your doctor should have the time and expertise to listen and recognize your symptoms not for what they ‘probably aren’t’ but for what they could possibly be.”
Trust Your Heart Health to Advanced Cardiovascular Specialists
Heart disease in women is alarming but it does not have to be fatal. Appropriate measures for heart health including screenings, healthy food choices, and exercise are key, as are knowing how to recognize the signs of a heart attack and taking action when symptoms arise.
Heart attacks can be largely preventable, but too many women either misunderstand or underestimate their risk. At Advanced Cardiovascular Specialists, we believe patient education is paramount to preserving heart health and preventing serious cardiac events, especially when it comes to women’s heart health. Since 1957, we’ve been pioneering coronary medicine in Southeast Texas, providing the comprehensive services and compassionate care women need to live their healthiest lives.
If the risk of heart attack is a concern for you or someone you love, don’t wait to find out. Contact Advanced Cardiovascular Specialists today to schedule an appointment.
The Silent Threat: Early Detection and Treatment as Shields Against Cardiovascular Diseases