Heart Attacks and Women
Heart attacks and their aftermath tend to be more deadly in women.
More women than men die within a year of having a heart attack. This may happen because women are generally older than men when they suffer heart attacks. Also, women don’t respond as well as men to the treatments usually prescribed during or after a heart attack.
For many women, a heart attack may feel like a strange discomfort in the back or some other easily ignored sign, instead of crushing chest pain.
When women do go to the hospital, doctors may miss the diagnosis of heart attack because the symptoms are vague. Without a definite diagnosis, a woman may be sent home thinking that her symptoms don’t mean anything serious.
Studies confirm that heart disease may differ in women in ways that doctors may not realize. Heart disease in many women doesn’t occur from obvious blockages in arteries as it does in men. Instead, for women, plaque often spreads evenly along the artery wall or in the smaller arteries—areas hidden from an angiogram, the standard imaging test that measures blood flow in the big arteries.
Many women have focal lesions, too. With this problem, which is called coronary microvascular syndrome, blood flow to the heart falls dangerously low. But they don’t often feel the “elephant-on-the-chest” pain that takes place when large arteries shut down. Instead, they may have subtle symptoms. They may feel pressure or squeezing or shortness of breath. Symptoms may even pop up elsewhere in the body, such as the jaw. (This symptom of jaw pain can also appear in men having a heart attack.)
The stage for heart disease is set before menopause by factors such as high blood pressure, high cholesterol, extra weight (especially around the waist) and smoking—all factors that play a part in plaque buildup.
Women's Heart Attack Symptoms
Women are more likely to have “nonclassic” heart attack symptoms than men. These are the most common warning signals for heart attack:
Pain or discomfort in the center of the chest that lasts more than a few minutes, or goes away and comes back
Chest discomfort with sweating
Pain that spreads from the chest to the arm, neck or jaw
Shortness of breath, tiredness or upset stomach; these are particularly common in women
If you are at risk for heart disease and have any of these symptoms, seek medical attention, up to and including calling 911, immediately. Time is a crucial factor in a heart attack because the longer the blockage remains untreated, the more heart muscle will die. Also, drugs that break down a blockage in the arteries (thrombolytic therapy) must be given within the first few hours after symptoms begin.