Women experience heart attacks differently to men meaning potentially deadly symptoms go undetected for longer, a charity has highlighted. Heart disease is the leading cause of death in the world, killing 17.5 million people according to the latest figures from 2012.
The American Heart Association has emphasised that while both men and women experience chest pains before or during a heart attack, women could also show more vague signs such as shortness of breath, nausea or vomiting, and neck or back pain.
A heart attack affects men and women in the same way, but the different sexes experience the symptoms differently. Many women even dismiss the symptoms. Dr. John Ryan talks about why women’s symptoms are different, what symptoms women should look out for and why women shouldn’t dismiss heart disease as just a man’s health concern.
Here’s some good news for all of you who received dark chocolate for Valentine’s Day: You’re eating something that is heart-healthy. The flavonoids found in dark chocolate are friendly to your vascular health and can lower blood pressure, improve blood flow to your brain and heart and make blood platelets less sticky and able to clot. But while you’re munching on your chocolate (and not too much of it!) be aware of this: Sometimes the reality of hearing that coronary heart disease not cancer is the number one cause of death for American women is startling.
Yet, the fact is that almost twice as many women die from a heart attack, stroke or other related forms of coronary heart disease than of all types of cancers combined and that includes breast cancer. Another startling fact: Since 1984, more women have died of cardiovascular disease than men. More than one in three women have some form of cardiovascular disease, according to the American Heart Association, with an overall increase in heart attacks occurring around 10 years after menopause.
We’ve all seen the movie scenes where a man gasps, clutches his chest and falls to the ground. In reality, a heart attack victim could easily be a woman, and the scene may not be that dramatic.
“Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure, ” said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center and an American Heart Association volunteer. “Instead they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue.”
Here are some staggering disparities:
- Women age 45 and younger are more likely than men to die within a year of their first heart attack.
- Only 65 percent of women said the first thing they would do if they thought they were having a heart attack was to call 9-1-1.
- Men are 2 to 3 times more likely than women to receive an implantable defibrillator for the prevention of sudden cardiac death.
- Previous studies and clinical trials have often been done with inadequate numbers of women in the study population, representing just 38 percent of subjects.
- In addition, 3/4 of cardiovascular clinical trials do not report sex-specific results, making it difficult for researchers and clinicians to draw conclusions about their effects on women.
And while it’s true that family history contributes to your risk, you can also take charge of your heart health by eating right (include fruits, veggies and whole grains), eliminating unhealthy habits (quit smoking, limit red meat and sugary foods and drinks) and getting plenty of exercise (aim for 150 minutes each week).
Since February is heart month, it’s always good to know the signs of a heart attack. Did you know they’re different for women? That could be one of the reasons why women are only half as likely as men to survive a heart attack. Either women and their health care professionals don’t recognize the symptoms, or medical personnel don’t associate women with heart attacks as readily as they do men.
Every minute in the United States, someone’s wife, mother, daughter or sister dies from a form of heart disease. And although heart disease death rates among men have declined steadily over the last 25 years, rates among women have fallen significantly less.
Why? A difference in symptoms between men and women may have something to do with it.
Men and women alike can experience the well-known heart attack symptoms like gripping chest pains and breaking out in a cold sweat. But women can also have subtler, less recognizable symptoms such as pain or discomfort in the stomach, jaw, neck or back, nausea and shortness of breath. As a result, women are often unaware that what they’re experiencing is a heart attack. So what happens? Women blow off the warning signs, assuming something else is the problem.
To add to the problem, women’s healthcare providers may misdiagnose these symptoms, and the result is that women discover their heart disease when it’s too late. Men, on the other hand, seem to benefit from having more frequently participated in clinical trials, and more aggressive diagnostic testing and treatment. So is it any wonder that heart disease is the No. 1 killer of women?
A heart attack is not always the classic feeling of an elephant sitting on your chest or a sudden, sharp pain that causes you to clutch your chest and collapse. Although the most common symptom for women is similar to men feeling chest pain or discomfort sometimes it’s subtler than that:
- You may feel short of breath as if you’ve done heavy exercise even though you haven’t exerted yourself at all. This can occur with or without chest discomfort.
- You might feel upper back pressure that may feel like there’s a rope around you, being squeezed.
- You may feel dizzy or lightheaded or may actually faint.
- You may feel jaw, neck, arm or stomach pain.
You might experience nausea or vomiting.
Many women attribute their symptoms to things like having the flu, being tired, experiencing acid reflux or normal signs of aging. Others may think they’re having a heart attack and simply take an aspirin, but not call 911, Neica Goldberg, MD, tells the American Heart Association. Dr. Goldberg, who is medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center, stresses that heart disease is preventable. She offers these tips:
Discuss your risk for heart disease with your health care provider
If you smoke, quit. After just one year, your risk of coronary heart disease can decrease by 50 percent.If you don’t already exercise, start now. Just 30 minutes of walking a day can make a difference. Even when the signs are subtle, the consequences can be deadly, especially if the victim doesn’t get help right away.
Learn to Recognize a Heart Attack
If you ask about the symptoms of a heart attack, most people think of chest pain. Over the last couple of decades, however, scientists have learned that heart attack symptoms aren’t so clear-cut. Symptoms may show up in several different ways and depend on a number of factors, such as whether you’re a man or a woman, what type of heart disease you have, or how old you are.
It’s important to dig a little deeper to understand the variety of symptoms that may indicate a heart attack. Uncovering more information can help you learn when to help yourself or your loved ones.
Early Symptoms of a Heart Attack
The sooner you get help for a heart attack, the better your chances for a complete recovery. Unfortunately, many people hesitate to get help, even if they suspect there’s something wrong.
Doctors, however, overwhelmingly encourage people to get help if they suspect they’re experiencing early heart attack symptoms. Even if you’re wrong, going through some testing is better than suffering long-term heart damage or other health issues because you waited too long.
Heart attack symptoms vary from person to person, and even from one heart attack to another. The important thing is to trust yourself . You know your body better than anyone. If something feels wrong, get emergency care right away.
According to the Society of Cardiovascular Patient Care, early heart attack symptoms occur in 50 percent of all people who have heart attacks. If you’re aware of the early symptoms, you may be able get treatment quickly enough to prevent heart damage. Eighty-five percent of heart damage happens in the first two hours following a heart attack.
Early symptoms of heart attack can include the following:
- mild pain or discomfort in your chest that may come and go, which is also called “stuttering” chest pain
- pain in your shoulders, neck, and jaw
- nausea or vomiting
- lightheadedness or fainting
- feeling of “impending doom”
- severe anxiety or confusion
Symptoms of a Heart Attack in Men
You’re more likely to experience a heart attack if you’re a man. Men also have heart attacks earlier in life compared to women. If you have a family history of heart disease or a history of cigarette smoking, high blood pressure, high blood cholesterol, obesity, or other risk factors, your chances of having a heart attack are even higher.
Fortunately, a lot of research has been done on how men’s hearts react during heart attacks.
Symptoms of a heart attack in men include:
- standard chest pain that feels like “an elephant” is sitting on your chest, with a squeezing sensation that may come and go or remain constant and intense
- upper body pain or discomfort, including arms, left shoulder, back, neck, jaw, or stomach
- rapid or irregular heartbeat
- stomach discomfort that feels like indigestion
- shortness of breath, which may leave you feeling like you can’t get enough air, even when you’re resting
- dizziness or feeling like you’re going to pass out
- breaking out in a cold sweat
It’s important to remember, however, that each heart attack is different. Your symptoms may not fit this cookie-cutter description. Trust your instincts if you think something is wrong.
Symptoms of a Heart Attack in Women
In recent decades scientists have realized that heart attack symptoms can be quite different in women than in men.
In 2003, the journal Circulation published the findings of a multicenter study of 515 women who’d experienced a heart attack. The most frequently reported symptoms did not include chest pain. Instead, women reported unusual fatigue, sleep disturbances, and anxiety. Nearly 80 percent reported experiencing at least one symptom for more than a month before their heart attack.
Symptoms of heart attack in women include:
- unusual fatigue lasting for several days or sudden severe fatigue
- sleep disturbances
- shortness of breath
- indigestion or gas-like pain
- upper back, shoulder, or throat pain
- jaw pain or pain that spreads up to your jaw
- pressure or pain in the center of your chest, which may spread to your arm
In a 2012 survey published in the journal Circulation, only 65 percent of women said they would call 911 if they thought they might be having a heart attack. Even if you’re not sure, get emergency care right away.
Base your decision on what feels normal and abnormal for you. If you haven’t experienced symptoms like this before, don’t hesitate to get help. If you don’t agree with your doctor’s conclusion, get a second opinion.
Heart Attack in Women Over 50
Women experience significant physical changes around age 50, when they go through menopause. During this period of life, your levels of the hormone estrogen drop. Estrogen is believed to help protect the health of your heart. After menopause, your risk of heart attack increases.
Unfortunately, women who experience a heart attack are less likely to survive than men. Therefore, it becomes even more important to remain conscious of your heart health after you go through menopause.
There are additional symptoms of a heart attack that women over the age of 50 may experience. These symptoms include:
- severe chest pain
- pain or discomfort in one or both arms, the back, neck, jaw, or stomach
- rapid or irregular heartbeat
Remain aware of these symptoms and schedule regular health checkups with your doctor.
Silent Heart Attack Symptoms
A silent heart attack is like any other heart attack, except it occurs without the usual symptoms. In other words, you may not even realize you’ve experienced a heart attack.
In fact, researchers from Duke University Medical Center have estimated that as many as 200,000 Americans experience heart attacks each year without even knowing it. Unfortunately, these events cause heart damage and increase the risk of future attacks.
Silent heart attacks are more common among people with diabetes and in those who’ve had previous heart attacks.
Symptoms that may indicate a silent heart attack include:
- mild discomfort in your chest, arms, or jaw that goes away after resting
- shortness of breath and tiring easily
- sleep disturbances and increased fatigue
- abdominal pain or heartburn
- skin clamminess
After having a silent heart attack, you may experience more fatigue than before or find that exercise becomes more difficult. Get regular physical exams to stay on top of your heart health. If you have cardiac risk factors, talk to your doctor about getting tests done to check the condition of your heart.
‘I thought I had the flu’
Even though heart disease is the No. 1 killer of women in the United States, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or normal aging.
“They do this because they are scared and because they put their families first,” Goldberg said. “There are still many women who are shocked that they could be having a heart attack.”
A heart attack strikes someone about every 43 seconds. It occurs when the blood flow that brings oxygen to the heart muscle is severely reduced or cut off completely. This happens because the arteries that supply the heart with blood can slowly narrow from a buildup of fat, cholesterol and other substances (plaque).
Watch an animation of a heart attack.
Many women think the signs of a heart attack are unmistakable the image of the elephant comes to mind — but in fact they can be subtler and sometimes confusing. You could feel so short of breath, “as though you ran a marathon, but you haven’t made a move,” Goldberg said.
Some women experiencing a heart attack describe upper back pressure that feels like squeezing or a rope being tied around them, Goldberg said. Dizziness, lightheadedness or actually fainting are other symptoms to look for.
“Many women I see take an aspirin if they think they are having a heart attack and never call 9-1-1,” Goldberg said. “But if they think about taking an aspirin for their heart attack, they should also call 9-1-1.”
Take care of yourself
Heart disease is preventable. Here are Goldberg’s top tips:
- Schedule an appointment with your healthcare provider to learn your personal risk for heart disease.
- Quit smoking. Did you know that just one year after you quit, you’ll cut your risk of coronary heart disease by 50 percent?
- Start an exercise program. Just walking 30 minutes a day can lower your risk for heart attack and stroke.
- Modify your family’s diet if needed. Check out these healthy cooking tips. You’ll learn smart substitutions, healthy snacking ideas and better prep methods. For example, with poultry, use the leaner light meat (breasts) instead of the fattier dark meat (legs and thighs), and be sure to remove the skin.
Most common heart attack symptoms for men and women:
- Discomfort, tightness, uncomfortable pressure, fullness, squeezing in the center of the chest lasting more than a few minutes, or comes and goes
• Crushing chest pain
• Pressure or pain that spreads to the shoulders, neck, upper back, jaw, or arms
• Dizziness or nausea
• Clammy sweats, heart flutters, or paleness
• Unexplained feelings of anxiety, fatigue or weakness – especially with exertion
• Stomach or abdominal pain
• Shortness of breath and difficulty breathing
Heart attack symptoms found to be more common in women:
- Pain in the arm (especially left arm), back, neck, abdomen or shoulder blades
• Jaw pain
• Nausea and vomiting
• Overwhelming and unusual fatigue, sometimes with shortness of breath
• Light headedness or sweating
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