Cardiovascular or heart disease is an all-encompassing term used to describe several problems of the heart and its related systems. Men and women both understand that the risks of heart disease need attention. However, some women don’t recognize that they are at risk for heart disease and may not seek prompt care when experiencing the signs of a heart attack. Symptoms in women may be more subtle than those in their male counterparts. As a result, they may be attributed to other non-life threatening conditions and ignored. Let’s look further into understanding heart disease in women and how to recognize it if you are at risk.

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Signs of a Heart Attack in Women

Heart attacks present several similar symptoms in both men and women, but there are specific symptoms in women that may be more subtle. Before exploring these signs, let’s discuss the misconceptions we may have about heart attacks, mostly stemming from television and movies. When a person suffers a heart attack in a movie, it is typically a man, clutching his chest and falling to the ground – no doubt a heart attack. The reality is that heart attacks can affect both men and women and symptoms do not always present so dramatically; they can be much more subtle, especially in women. In fact, some women don’t have symptoms at all!

Some signs that both men and women share include:

• Chest pain (angina) in the middle or left side of the chest
• Feeling faint or weak – breaking out in a cold sweat
• Jaw and neck pain
• Shoulder and back pain (the left side is more common, but both sides may be involved)
• Shortness of breath, which may occur before chest pain

Women may have subtly different symptoms of a heart attack, including:

• Mild or no chest pain
• Nausea and vomiting
• Tiredness and profound fatigue
• Serious indigestion

These more subtle symptoms often lead to a delay in calling 9-1-1. Some women may believe they are suffering an anxiety attack instead and dismiss the signs. Because of this, they may take hours or even days to get to the hospital, by which time more damage has been done.

Pre-Heart Attack Signs in Women

In some cases, our bodies give us pre-heart attack warning signs that, if heeded, allow us to contact our doctor or get to the emergency room before a heart attack takes place. Some non-specific signs may include unexplained fatigue, feeling as if you have the flu or feeling like you strained a muscle in your chest of upper back. The symptoms listed above are also precursors to a heart attack, so do not ignore them, even if they seem mild or insignificant.

In other cases, heart disease has no outward symptoms – this is referred to as “silent heart disease”. A silent heart attack can be just as serious and cause the same damage as a more obvious heart attack. It can reduce blood flow and cause the same scarring to the heart. Because no medical action was taken, the impact of a silent event can be even greater. In these cases, heart disease in women is only discovered when they are admitted to the hospital, suffering a heart attack or in heart failure.

Women’s Average Heart Attack Age  

The average age of women who suffer a heart attack is 69 years old. This is about eight years later than for the average for men. Your chances may go up if you have one or more risk factors for heart disease and heart attacks, as is the case with a significant portion of the female population. Furthermore, over 6% of women over age 20 live with cardiovascular disease, many of whom don’t even know it.

How We Can Prevent and Start Reversing Heart Disease in Women

The various conditions that make up the general term “heart disease” fall on a spectrum of risk. Heart disease is progressive but, in some cases, can be reversed with or without medical intervention. Many heart attacks and other cardiovascular events can be preventable, and it’s never too late to pay attention to your heart. Here are some tips to get you started on the road to better heart health:

Understand Your Inherent Risk

If a close family member has experienced heart disease, especially at a young age, or if they died prematurely from cardiovascular disease, you are at a higher risk. Speak to your primary care physician and cardiologist about enhanced screening. Does this mean you are destined to have heart disease? No! It just means you will need to be more vigilant.

Cancer Patients

When undergoing radiation and/or chemotherapy, you are at greater risk of heart damage resulting from these therapies. This is known as cardiotoxicity and represents a long-term risk. Speak to your oncology team about cardiotoxicity and loop in your cardiovascular specialist at the start of your cancer treatment.

Lifestyle Choices and Medical Conditions

Be sure to understand and monitor the medical and lifestyle factors that increase the risk of heart disease, including obesity, diabetes, high blood pressure (over 120/80), high cholesterol (over 200), and high fasting blood sugar (over 100). Behavioral choices, such as a sedentary lifestyle, unhealthy diet, excessive alcohol use and smoking, significantly add to the risk for heart disease. Losing weight, improving diet, increasing physical activity and quitting smoking can vastly improve or eliminate your risk.

Address Cardiac Arrhythmias

Arrhythmias like Atrial Fibrillation (Afib) increase your risk of a heart attack and stroke by up to five times! If you are feeling chest palpitations, flutters, or other issues, visit your cardiologist or electrophysiologist to address the underlying cause.

Increasing Awareness of Heart Disease in Women

Despite everything we know about heart disease and its increasing prevalence in modern-day life, only about 56% of women realize that it’s the leading cause of death among women in the United States. This must change.  Here are the key points that women of all ages must understand:

• Heart disease profoundly affects women, too. It is not just a man’s disease. Approximately 20% of all US deaths in women are related to heart disease.
• Women tend to wait too long to get emergency care. The symptoms and signs of a heart attack in women are often more subtle and may be dismissed or ignored. Call 9-1-1 or visit the ER promptly if you experience any of the symptoms above.
• Doctors need to improve, too! We have made strides in understanding women’s heart disease, but all too often, legitimate cardiovascular concerns are dismissed as anxiety or stress.

Together, we can turn the tide in diagnosing and treating women’s heart disease. We must be vigilant and understand our risks. Further, we must include our medical team at the first signs of cardiovascular problems, setting aside preconceived notions. Never has “Better Safe Than Sorry” been more relevant than it is today with our heart health.

Meet Dr. Ahmed, Cardiologist with Florida Medical Clinic Orlando Health 

Your heart health is central to your overall health and wellness. Heart disease affects both men and women and managing your risk factors may save your life.

Sameer W. Ahmed, MD is board certified in Cardiovascular Disease, Echocardiography and Nuclear Cardiology. He specializes in heart disease and preventative cardiology. To learn more about Dr. Ahmed’s approach to cardiovascular health, request an appointment. 

Disclaimer: This post is not a substitute for medical advice, diagnosis, or treatment from a licensed medical professional.