Heart disease in women: Understand symptoms and risk factors

Although heart disease is often thought of as a problem for men, more women than men die of heart disease each year. In fact, heart disease kills more women than all cancers combined.

One challenge is that heart disease symptoms in women can be different from symptoms in men. Some people picture a Hollywood heart attack — gripping the chest with crushing chest pain — but women, in particular, tend to have much more subtle symptoms.

This may be because women tend to have blockages not only in their main arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel heart disease or microvascular disease.

The most common heart attack symptom in women is some type of pain, pressure or discomfort in the chest. But it's not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have heart attack symptoms unrelated to chest pain, such as:

• Neck, shoulder, upper back or abdominal discomfort
• Shortness of breath
• Nausea or vomiting
• Sweating
• Lightheadedness or dizziness
• Unusual fatigue

Fortunately, women can take steps to understand these symptoms and to begin to reduce their risk of heart disease.

Many women tend to show up in emergency rooms after much heart damage has already occurred because their symptoms are not those typically associated with a heart attack. If you experience these symptoms or think you're having a heart attack, call for emergency medical help immediately. Don't drive yourself to the emergency room unless you have no other options.

Women frequently delay going to the hospital when they’re having a heart attack because they often put others’ needs first, caring for children, spouse or aging parents, and they ignore their own health.

Heart disease risk factors for women

Although the traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:

• Metabolic syndrome — a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides — has a greater impact on women than on men.
• Mental stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you’re having symptoms of depression.
• Smoking is a greater risk factor for heart disease in women than in men.
• Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).