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Story highlights
Women are more likely to have atypical symptoms of a heart attack
Heart disease affects women differently than it affects men in several ways.
Be aware of risk factors that affect 44% of U.S. women
CNN
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According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for women in the United States, accounting for approximately 1 in 5 women. More than 60 million American women have some form of heart disease, and just over half (56%) recognize that heart disease is the leading cause of death among women.
What types of heart disease should women be aware of? Does heart disease affect women and men differently? What symptoms can indicate heart problems? What should I do to improve my health?
To answer these questions, I spoke to CNN wellness expert Dr. Leena Wen. Wen is an emergency physician, and George is an adjunct associate professor at the University of Washington. She previously served as the health commissioner for the city of Baltimore.
CNN: What types of heart diseases should women be aware of?
Dr. Liana Wen: Heart disease is an umbrella term that includes several cardiovascular diseases.
Coronary artery disease is the most common type of heart disease. This occurs when the arteries of the heart become narrowed or blocked by plaque made of cholesterol deposits. Coronary artery disease and vascular disease, or disease of the blood vessels, are the leading causes of heart attacks and strokes. Risk factors for coronary artery disease include medical problems such as high blood pressure, high cholesterol, and diabetes. obesity; and smoking.
Another type of heart disease is abnormal heart rhythm. For example, atrial fibrillation occurs when the heart beats irregularly. This can lead to blood clots and complications such as stroke and heart failure.
Heart failure itself is another form of heart disease. This occurs when the heart is damaged or weakened in some way. Causes of heart failure include heart attack. Chronic diseases such as high blood pressure and excessive alcohol consumption. and some viral or bacterial infections.
There may also be abnormalities in the structure of the heart itself, such as defects in the heart valves or holes in the heart wall. Some of these are congenital, meaning they are present from birth. Or it may develop over time due to infection, disease, or other factors.
CNN: Does heart disease affect women and men differently?
Wen: In a way, yes. This begins at birth. This is because the size and structure of the heart is different for men and women, and women generally have smaller hearts and blood vessels than men. Studies have shown that women are more likely to develop heart disease in the small arteries of the heart. This is more difficult to diagnose than problems with larger arteries and contributes to a higher rate of missed diagnoses in women.
Additionally, hormonal changes, such as changes in estrogen levels, occur during a woman’s life and can also affect her risk of coronary artery disease. Women are also more likely than men to have certain conditions that increase the risk of heart disease, such as anemia and endometriosis.
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Heart disease is the leading killer of women in the United States.
CNN: Are there any heart problems that specifically occur during pregnancy?
Wen: There are medical conditions that can develop during pregnancy that can affect a patient’s heart health during pregnancy and beyond. These include common conditions such as gestational diabetes and high blood pressure and, less commonly, very serious problems such as an enlarged heart that can lead to heart failure.
You may also have a pre-existing heart condition that doesn’t show symptoms until your body is stressed during pregnancy and childbirth. For example, you may have had blood pressure problems for years but didn’t realize it until you became pregnant. Women of childbearing age should be aware of these conditions and pay attention to their heart health before, during, and after childbirth.
CNN: What symptoms should a woman seek immediate emergency treatment for?
Wen: Typical symptoms of a heart attack are chest pain, pain in the jaw and neck that extends to the left arm, shortness of breath, lightheadedness, and nausea. Not all of these symptoms may be present or there may be variations. For example, a person may not say their chest hurts, but they may have a feeling of heaviness or a dull ache in their chest. You may have pain in your upper abdomen, back, and shoulders.
Women are more likely than men to experience vague and atypical symptoms such as fatigue, nausea, and upper abdominal discomfort. Studies have reported that women are more likely to be misdiagnosed than men. Their heart attack symptoms can ultimately be attributed to heartburn and psychiatric symptoms. In one study, almost half of the women did not show the typical signs of a heart attack.
CNN: What about heart problems other than heart attacks? What are the red flags?
Wen: People with abnormal heart rhythms may experience palpitations or feel like their heart is suddenly beating rapidly and irregularly. You may experience dizziness or fainting. People with congestive heart failure may gradually lose their ability to exercise and begin to feel tired after walking a short distance. You may notice swelling in your legs and need an extra pillow to sleep more comfortably at night.
All of these can be rather subtle symptoms. My takeaway here is to listen to your body and don’t wait to seek care. If you don’t feel right, be sure to speak up for yourself. Discuss how the symptoms you are experiencing are unusual. Put it into the context of your life so that the point is clearer to the clinician. For example, if he used to speed walk for 30 minutes every day, but now he can’t walk down the block without a breeze, that’s all important information to convey.
CNN: What should women do to improve their heart health?
Wen: The most important thing is to recognize and manage existing medical conditions that increase your risk of heart disease. High blood pressure is one such risk factor. More than 56 million American women have high blood pressure. This equates to 44% of adult women in the United States. Although the incidence of high blood pressure increases with age, many young women also have this condition. According to the U.S. Centers for Disease Control and Prevention, nearly 1 in 5 women of reproductive age have high blood pressure.
According to the CDC, fewer than 1 in 4 women with high blood pressure have the condition under control. Keeping your blood pressure under control and optimizing it through lifestyle changes and medication as needed is key to reducing your risk of heart attack, stroke, and other cardiovascular complications.
The same is true for women with diabetes and high cholesterol. Obesity is also a major risk factor, as is smoking, excessive alcohol consumption, unhealthy diet, and lack of exercise. Women should also not underestimate the role of stress, sleep, and mental health, which can also affect heart health.
