Women won’t often seek care for a heart attack, because they don’t suffer what we know as the traditional symptom – chest pain. McLeod Cardiologist Alan Blaker, MD explains the signs women should look for and some of the unique risk factors women have.
Here is a summary of Dr. Blaker’s comments:
Both women and men can have heart disease and can present with heart attacks. In women the symptoms can be a little different from men.
Heart attack symptoms in women often differ from men in the type of pain and where it is located. In women, the pain can sometimes be in the shoulder or the back. The more common type of pain, especially with men, associated with heart disease or heart blockages is pain in the center of the chest.
Women can also have pain in the center of the chest which radiate to the arm and the neck; however, atypical pain, which is more common in women occurs just in the arm, just in the back, or really anything above the diaphragm. In some cases, women feel no discomfort and complain only of shortness of breath or excessive fatigue, especially in diabetics.
Because women’s symptoms are different from men, sometimes they don’t seek care right away. They may attribute their pain to arthritis or other types of musculoskeletal type pain. So, they present a little later after the pain has gone on. Whereas, men may come in sooner with the pain because it is more typical of heart problems.
Because women’s symptoms differ from men, typically they won’t seek care right away. Women may attribute their pain to arthritis, other types of musculoskeletal pain or indigestion. Because their symptoms are less typical for a heart attack, women or some men for that matter, will wait until the pain has lasted a long time before taking action. Others will come to the Emergency Department sooner if their pain is more typical of heart problems. It is important for anyone having recurrent pain or unusual shortness of breath to seek medical attention without waiting too long.
Anyone with pain that starts and won’t go away within 30 minutes ought to be seeking medical attention, certainly sooner if the pain is severe and new for them. If the pain is intermittent, particularly if it occurs with exertion, seek medical attention as soon as you can, to be evaluated.
Women also have unique risks factors which can lead to heart problems. Some of these risk factors may be related to hormones or even pregnancy. Research has also shown that heart attacks can occur with women who take birth control pills. In addition, if a woman smokes while using birth control; her risk of having a heart attack is much, much higher.
Risk factors that apply to both men and women are extremely important to control, particularly for anyone who already has been diagnosed with heart disease. These risk factors include hypertension, diabetes, and a family history of early heart disease – which usually means a heart attack or heart disease below the age of 55 or 60 – cigarette smoking, or elevated cholesterol. From this list we have what we call the modifiable risk factors, which are hypertension, diabetes, smoking and elevated cholesterol. Modifiable means you can modify, or change, them. They are risk factors that can be controlled. Controlling your blood pressure and blood sugar if you have diabetes, quitting smoking and keeping your cholesterol levels in check are important steps to modifying those risk factors. We can’t change family history, but an individual – male or female – with a family history of premature heart problems should seek prompt evaluation if having symptoms that could be related to blockage problems.
Controlling weight and other modifiable risk factors would be the best chance a woman has to reduce her risk for heart disease or to prevent a second heart attack.
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