Your Weekly Checkup: What You Need to Know about Heart Disease in Women

One in four women die of heart-related problems. Learn the warning signs of heart attacks in women.

Woman grasping her shirt around the chest area, simulating a heart attack.

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“Your Weekly Checkup” is our online column by Dr. Douglas Zipes, an internationally acclaimed cardiologist, professor, author, inventor, and authority on pacing and electrophysiology. Dr. Zipes is also a contributor to The Saturday Evening Post print magazine. Subscribe to receive thoughtful articles, new fiction, health and wellness advice, and gems from our archive.  

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Every 40 seconds, someone in the U.S. has a heart attack.

The American Heart Association has led the effort to educate women about their risk of heart disease, stressing that more women die of heart related problems (1 in 4) than of breast cancer. In fact, the AHA has stated that “Every minute in the United States, someone’s wife, mother, daughter or sister dies from heart disease, stroke or another form of cardiovascular disease.”

Each year, more than 30,000 women younger than 55 years old are hospitalized with an acute heart attack. Importantly, women may be more likely than men to experience lesser-known heart attack symptoms such as chest pressure, tightness, or discomfort, in addition to chest pain. The pain and discomfort can be in the jaw, neck, arms, or between the shoulder blades. Heart attack symptoms unrelated to chest pain can include shortness of breath, a cold sweat, nausea or lightheadedness. Misinterpreting such heart attack symptoms can put women at a greater risk of death.

Young women with an acute heart attack may have more health conditions such as congestive heart failure, hypertension, renal failure, chronic obstructive pulmonary disease, and diabetes mellitus. They may also experience a longer length of stay in the hospital and have higher in-hospital mortality than men. Women with a history of autoimmune diseases such as lupus, rheumatoid arthritis, or psoriatic arthritis, as well as a history of preeclampsia, hypertension during pregnancy, and gestational diabetes, have increased risk for heart disease.

Some women may not have obstructions in the large coronary arteries that men exhibit but rather have involvement of small coronary arteries that may escape notice but are still able to cause a heart attack.

Women undergoing procedures such as coronary artery stent placement or coronary artery bypass surgery may experience worse outcomes than men, a finding possibly related to other health conditions and increased surgery-related complications.

Women need to be aware of their heart disease risk, how symptoms can present, and the potential outcome. Prevention is the fundamental order of the day, which can be impacted by healthy lifestyle choices such as a proper diet, exercise, blood pressure control, and smoking cessation. A happy marriage helps.

Finally, if you suspect you are having heart problems, do not hesitate to call your health care professional, or 911 if it’s an emergency. Do not worry about false alarms. It is better to be safe than sorry.

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