Why heart disease looks different for women


Oct 02, 2014 by Smart Blog

In the US, since 1984 the number of women dying from heart disease exceeded that of men. While heart disease in men has been in a steady decline, female deaths from heart disease have tended to increase. This is echoed in other countries and is in stark contrast to the great progress that has been made in other areas of female health. In the UK, for example, heart disease now kills three times as many women as breast cancer does.



The question is, of course, why is this happening? A major part of the problem lies in the way that heart disease presents in women, which is often very different from the way that it manifests in men. In addition, some medical professionals tend to assume that heart disease always 'behaves' the way that it typically does in men; therefore, they can miss the signs of heart disease in women.

For example, most people have seen a 'typical' heart disease on a TV drama or in a film. The victim clutches their chest in pain and drops to the floor in a sudden, dramatic episode. That is the way most men experience heart attack, and it can also be true for some women - but by no means all. In fact, in an American study of more than 500 women who had suffered a heart attack, scientists found that more than forty per cent of them did not experience any acute chest pain at all. Instead, these women reported a range of symptoms that included: 

  • Shortness of breath.
  • Extreme fatigue.
  • Nausea.
  • A feeling of having indigestion.
  • General weakness.

In some cases, women had reported these symptoms in the days or even weeks leading up to their heart attack. However, perhaps because the medical staff they consulted were unfamiliar with the differing presentations of heart disease in men and women, some were sent away because their symptoms were vague, or because they were attributed to other things such as indigestion and anxiety.

The internal actions of heart disease differ between men and women too, for example plaques of fat on women's arteries are often more smooth and difficult to detect with medical equipment than the male equivalent.



The outcomes of this are often fatal. Worldwide, some women are dying of heart disease because the symptoms that they report, being less immediately recognised than those of the more typical male version, are overlooked and their heart disease is left untreated. This is a huge waste of life, because prompt intervention in heart disease and heart attack can and does save lives, every day.

Fortunately, doctors are becoming more aware of this issue and there are some promising options on the horizon, such as the use of MRI imaging to detect the less obvious 'feminine' arterial plaques. However, in general research into female-specific heart disease is several years behind that of men.

In the meantime, all women should make sure they are aware of these 'alternative' symptoms of heart disease, and report them promptly to a doctor. Keeping blood pressure and cholesterol under control are also sensible measures.