The Gender Differences of Heart Disease and Heart Attacks

heart disease by gender
How heart problems are different for women, and why it matters
By Healthy Magazine Staff

Men and women are quite different, to state the obvious. But one difference that might not get enough attention is how heart disease often presents itself differently, according to gender.

In women, heart attacks tend to occur later in life (about ten years later, on average, than men), but are also more severe. They are also more likely to die from the first heart attack and more likely to be disabled, research shows.

“There has been a misconception that women were immune to heart disease. Not only do women have heart attacks but they can be deadlier in women than in men,” said Dr. Nieca Goldberg, a cardiologist and spokeswoman for the American Heart Association.

Particularly concerning is that younger women who have heart attacks have a drastically higher death rate than men the same age who have heart attacks, Goldberg says. Heart disease is the No. 1 killer of American women, claiming nearly 500,000 lives each year.

Hearts Beat Differently

The size and pumping ability of the right side of the heart differs by gender. The right ventricle is smaller in women than in men.

Source: Circulation: Journal of the American Heart Association

One way to reduce the risks is to know that warning signs of a heart attack can be very different in women than men.

“Women are much more likely to have atypical heart attack symptoms,” says Dr. Lili Barouch, Assistant Professor of Medicine, Division of Cardiology, Johns Hopkins School of Medicine. “So while the classical symptoms, such as chest pains, apply to both men and women, women are much more likely to get less common symptoms such as indigestion, shortness of breath, and back pain, sometimes even in the absence of obvious chest discomfort.”

Because what women feel in a heart attack may not be like what has been described to them by medical professionals (no chest pain, for example), they can misinterpret what they are feeling.

Here is a guide for women to better recognize symptoms of a heart attack:

  • Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
  • Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  • Shortness of breath with or without chest discomfort.
    Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
Source: American Heart Association (AHA)

According to the AHA, women can mistake a heart attack for the flu, acid reflux or normal aging.

Furthermore, risk factors for heart disease differ by gender. Traditional risk factors for both men and women include obesity, smoking, diabetes, high blood pressure and family history.

Risk Factors For Women Specifically

  • High testosterone levels in menopause.
  • Increasing hypertension during menopause.
  • Autoimmune disease like rheumatoid arthritis.

Some researchers suggest that certain diagnostic tools may be better than others for women, meaning that while an electrocardiogram might be good for a man, a stress test might be better for a women.

Cardiology tests performed on women are sometimes misinterpreted, according to the Women’s Heart Foundation, because plaque in men’s arteries clumps, whereas in women’s arteries plaque distributes evenly throughout artery walls.

The bottom line is that heart care cannot be a one-size-fits-all approach.

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