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Heart Disease in Women

Updated: Nov 24, 2023

A female doctor is listening to the heart of her female patient using a stethoscope.  The room has periwinkle walls with a white shelf, a clock is on the wall, and there is a scale off to the side.

When you think about heart disease, you might automatically think about an older, slightly obese man who comes to the emergency room clutching his chest. But women, too, can develop heart disease — it's the number one cause of death in women, according to the Centers for Disease Control. Heart disease in women presents somewhat differently than in men, so it's essential to recognize the symptoms and understand the preventative steps you can take to stay healthy.

How women's heart disease is different

Dr. Amrita Karve, a cardiologist at the Mount Carmel health system in Columbus, Ohio, is a specialist in women's heart disease and founded Mount Carmel's women's heart program. She says women's health and heart disease was put on the back burner for years. Clinical trials focused on male subjects primarily because men don't have the hormonal fluctuations caused by pregnancy and menopause.

In the past decade, the focus has shifted to women's cardiology because of the differences in how heart disease present in females.

"With men, blockages in the arteries and the large vessels are more apparent. Those cause a sudden obstruction in blood flow, which causes the heart muscle that receives that blood to die because it's not getting oxygen," she explains. "But what we're finding in women is there can be some muscle death of the heart muscle even without the traditional large blockages men get. In women, the occlusions are in much smaller vessels."

The traditional risk factors for heart disease have no gender difference. These include:

• Family history

• Smoking

• Diabetes

• Being overweight

But women have additional risk factors to contend with. These include:

• Autoimmune diseases like lupus or rheumatoid arthritis

• Complications of pregnancy, including preeclampsia or gestational diabetes

• Treatment for cancer, such as radiation to the chest and certain chemotherapies

Blockages alone aren't the only potential issue. Heart failure, electrical conduction issues, or complications with valves can also occur. And some of the same risk factors that are specific for women for coronary artery disease are the same for some of these heart conditions as well.

"Some differences between valvular heart disease and conduction, and heart failure can be heavily influenced by autoimmune disease and cancer chemotherapy and radiation. So any woman with an autoimmune disease or breast cancer is at higher risk for these complications," says Dr. Karve. "In fact, there's a whole new world of cardio-oncology being developed, dedicated to just the overlap between cancer treatments and heart disease.”

Another factor in developing heart disease is ethnicity. Blacks, Hispanics, and Native Americans are all recognized to be at higher risk for heart disease than Caucasians. But recently, research has found that both South Asians and Asians can be at risk for developing heart disease at a lower Body Mass Index (BMI).

Prevention is key

The first step to understanding your personal risk for heart disease is to get a routine physical, including blood work, to monitor blood pressure and detect cholesterol levels and blood sugar. But, according to Dr. Karve, other screening tests, such as a calcium score CT, can further calculate your risk of developing heart disease. Maintaining a healthy weight and exercising at are critical tactics to reducing the risk of heart disease, as is reducing stress and getting enough sleep.

Symptoms of a heart attack for women

What are the symptoms of a heart attack in women? The most common symptom for men and women is chest pain. Other symptoms can include:

• Jaw pain

• Shoulder pain

• Neck pain

• Shortness of breath

• Indigestion

• Nausea

• Vomiting

• A feeling of pressure on the chest

• Panic or anxiety

Take these symptoms seriously and get medical attention immediately.

Knowledge is power

Heart disease is a serious health concern for women. You can reduce your risk of heart disease by understanding your risk factors, being aware of symptoms, and actively taking preventative steps. By taking these actions, we can work towards reducing the number of deaths caused by heart disease in women.



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