written by john c ashworth, ma
Why a woman's risk for heart disease is greater than she thinks.
Most of us are familiar with the classic signs of a heart attack - chest pain or pressure, cold sweats, light-headedness, or radiating pain down your left arm. The problem for women is that the signs and symptoms often present very differently. Here is what you need to know...
The first point I want to share is that for about five years I spent time in my career working as a clinical exercise physiologist in preventive cardiology. During that time, I worked closely with women recovering from a heart attack, heart catheterization, or bypass surgery. The surprising fact is that many of these women admitted that their symptoms for heart disease had presented very differently than the typical signs listed above. In fact, many of them told stories of long periods of time prior to their heart events or procedures where they experienced extremely high levels of fatigue. Following their procedures, they could not believe how much better they felt, nor the idea that the fatigue they had been experiencing was related to their heart disease.
Leigh and I did a segment on this many years ago, and following a recent article I read in The Nutrition Action Letter on this subject, I thought it time to re-visit this important topic for women. A stroke may also show up differently for woman so we will cover that too.
Here's what women need to know about how their risk or signs of heart attack, stroke, arthritis, and osteoporosis may differ from men's.
It is probably important to start with the fact that what causes heart attack and stroke in women is the same for both men and women. Smoking, high cholesterol levels, high blood pressure, inactivity, taking the elevator, excess weight, diabetes, and family history are all risk factors that top the list. When it comes to the symptoms, however, the experience can become quite different.
Women, for example, are more likely to experience their chest pain as sharp and burning, and they more frequently report nausea, fatigue (as I described above), difficulty breathing or shortness of breath, dizziness, or jaw, neck, and upper body and back pain. Another interesting layer, is that a woman's symptoms are more likely to be triggered by stress, rather than exertion.
This is a real problem, for both women and men. Most women are likely to believe that they are more likely to die of breast cancer than heart disease. Forty thousand American women die of breast cancer each year. However, by age 55, heart disease deaths surpass breast cancer deaths, and after the age of 75, heart disease kills eight times more woman than breast cancer.
Adding yet another layer to the problem, is that many of our current diagnostic tests for heart disease are more accurate for men than for women. Heart disease, it turns out, can develop differently in women than in men. Men tend to have blockages in their larger more prominent coronary arteries, while women tend to present with disease in the smaller more peripheral arteries that are both harder to stent during catheterization, and harder to find during and angiogram. To put this in perspective, the arteries in which women tend to develop heart disease are no wider than a human hair. The problem for women is not that the plaque is "blocking" an artery, but instead that the inner walls of a woman's arteries become damaged and can cause spasms, which in turn can cutoff the blood flow. This is why stress is a more common cause of heart attack for women. Stress can increase the likelihood of coronary artery spasms.
Bottom Line: Know the Symptoms
The following symptoms can signal a heart attack in both women and men. But remember, women are more likely than men to report upper body discomfort, including sharp pains, difficulty breathing, fatigue, or nausea.
Symptoms of a heart attack - don't die being stubborn. If you are experiencing any of the following symptoms, call 911 and/or discuss them with your physician.
- Chest Pain or Discomfort
- Unusual upper body discomfort
- Shortness of breath
- Breaking out in a cold sweat
- Unusual or unexplained fatigue (tiredness)
- Lightheadedness or sudden dizziness
- Nausea (feeling stick to your stomach)
*Note: this post was adapted and written with facts derived from the following article in the September 2015 Issue of The Nutrition Action Letter. Click here to subscribe to this fantastic publication.
