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Heart Attack & Women

A heart attack occurs when blood flow to a section of heart muscle becomes blocked. If the flow of blood isn’t restored quickly, the section of heart muscle becomes damaged from lack of oxygen and begins to die.

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Cardiovascular disease claims more female lives than breast cancer, accidents and diabetes combined. Worldwide, heart disease is the number one killer of women.

Heart Attacks in Women

Heart Attacks can affect women of all ages. It is especially prevalent after menopause. Coronary artery disease rates in women after menopause are 2 to 3 times those of women the same age before menopause. Heart attack is especially dangerous among women. Although women are about as likely as men to have a heart attack, they are more likely to die within a year after their first heart attack.

Women tend to have “atypical” symptoms that are actually signs of a heart attack. As a result, it may be harder for women to recognize they are having a heart attack and to get treatment immediately. Physicians may also have a hard time diagnosing a heart attack in women because of the atypical symptoms women are more likely to have. Women’s heart attacks may be more damaging or associated with more severe medical complications, possibly because of the underreporting and late diagnosis that may result from presenting with atypical symptoms.

Compared with male heart attack patients, women are usually about 10 years older at the time of their first attack. At that age, they are more likely to have medical complications or conditions that could interfere with a full recovery. At the more advanced age, women are more likely to have conditions such as diabetes or high blood pressure (hypertension). They are also more likely to have developed complications from long-term habits such as smoking or excessive alcohol use. It is important to note that, while women are more likely to suffer a heart attack after menopause, younger women can get heart attacks that are just as life-threatening.

Women have a smaller heart and coronary arteries than men, which makes some diagnostic and therapeutic procedures more difficult. Non-invasive imaging of the heart may be difficult due to the interference of breast tissues.

What Causes a Heart Attack?

A number of risk factors increase a woman’s chance of developing coronary artery disease (CAD) and having a heart attack.

  • Smoking:  A regular smoking habit (including cigars and marijuana) greatly increases the risk of damage to the coronary arteries (more so in women) and dying from heart disease. Chronic exposure to second-hand smoke at work or other places also increases the risk, even in nonsmokers.
  • High blood pressure (hypertension): High blood pressure is more common among men than women until age 55. Between ages 55 and 74, it is slightly more common among women, and over the age of 75, many more women have high blood pressure than men.
  • Cholesterol Levels:  Low levels of HDL and High levels of LDL can lead to heart problems. A good balance of the HDL and LDL should be maintained.
  • Triglycerides: Women should also carefully monitor their levels of triglycerides, another type of fat in the blood.  
  • Diet: An unhealthy diet like consumption of saturated fatty food cause the liver to produce higher levels of cholesterol and therefore increase the risk of heart disease.
  • Obesity and Overweight: Obesity is the second leading cause of preventable death, contributing to serious health problems such as heart disease, diabetes, cancer and stroke. Obese individuals are much more likely to die from a heart attack than those who are not.
  • Inactive Lifestyle and lack of regular exercise: Heart disease is twice as likely in inactive woman than in those who get regular exercise – at least 30 minutes three times per week.
  • Hereditary:  women are more likely to develop heart disease if it runs in the family.
  • Diabetes. Regardless of blood sugar control, diabetic women are twice as likely to suffer from heart disease as non-diabetic women.
  • Estrogen Levels: Women who are going through menopause have a greater risk of heart diseases.

Signs and Symptoms

The warning signs of a heart attack are:

  • Chest pain or discomfort that is unrelieved by rest or a change in position and often spreads or radiates through the upper body to the arms, neck, shoulders or jaw. The sensation tends to be very intense and unrelieved by medication.
  • A feeling of severe heartburn in the upper abdomen or pain in the breast.
  • Profound fatigue.
  • Chest-area pressure or squeezing sensation that may be either constant or intermittent.
  • Shortness of breath or shallow breathing.
  • Abnormally weak and/or fast pulse.
  • Feeling faint or dizzy.
  • Sweating, often heavy and often cold.
  • Nausea or upset stomach.

Unless a woman is familiar with these symptoms, she may delay getting to the hospital. By the time a woman decides to seek medical attention, severe damage to the heart may already have occurred. When in doubt, chew a “regular” aspirin (not acetaminophen) if you are not allergic or don't have an ulcer. Aspirin can greatly reduce the chance of dying from a heart attack.

When meeting with a healthcare professional during an emergency, women should communicate the nature of the apparent health crisis and their need for tests (e.g., blood tests and an EKG) to be run as soon as possible. These may include tests measuring cardiac enzymes and C-reactive protein. Women who are concerned about their heart health are encouraged to seek a second opinion if they are not satisfied with the first.

Prevention and Treatment

Once a heart attack has been diagnosed, treatment is generally the same for both men and women. It is important that treatment be sought as quickly as possible. Rapid treatment can reduce the muscle damage associated with a heart attack. 

For both women and men, the best strategy for preventing heart attacks is to make lifestyle changes that help prevent the main cause of heart attacks: coronary artery disease.

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