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Heart attacks in women vs. heart attacks in men

Recognizing when your heart is in distress varies – even though keeping it healthy looks the same

April 26, 2017

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The statistics are clear. In the United States, more people die of heart disease than any other factor.

More than 24 percent of men and 22 percent of women die from heart-related illness. That’s according to the latest data from the Centers for Disease Control and Prevention (CDC). And that means heart disease is topping other common killers like stroke and cancer.

Men and women face the same challenges in keeping their heart healthy. But the symptoms and warning signs of heart disease can be very different for the two sexes.

Andrew Smith, MD, is a cardiologist who sees patients at the Park Nicollet Heart and Vascular Center. We asked him a few questions about how a heart can present differently for men and women.

What are some subtle early warning signs of heart attack in women?

Dr. Smith: Unlike men, women’s chest symptoms have a tendency to start while they are at rest, asleep or experiencing mental stress. This makes everyone think the symptoms come from other sources, like gastrointestinal distress.

Recently, we’ve found that young women are having another kind of heart event more commonly, too. Spontaneous coronary artery dissection (SCAD) can feel exactly like a typical heart attack, but it occurs in a young healthy woman who does not have the typical risk factors. When it happens, the inside skin of the heart vessels tears for no clear reason. We are now seeing more active, athletic women experiencing chest pain while participating in sporting events. They think they are too healthy for this pain to be a heart attack, and we actually see some of them finish their event while they are having this type of heart attack.

Why is it so important to notice the early warning signs of a heart attack?

Dr. Smith: Cardiovascular diseases are the No.1 cause of death and disability among women. Current studies show they make up one-fifth to one-third of serious health events for women. Yet, surveys still show that few women fully understand their own personal health risk factors.

Are heart attack symptoms different for women and men?

Dr. Smith: Most large studies suggest that when women complain of heart attack symptoms, the symptoms are quite similar to men. Chest pain, pressure or tightness represent the most frequent symptoms. The problem is that women often are having heart problems even if they are having no symptoms at all. Then, when they finally do report that something is wrong, they are more ill. Overall, heart disease typically happens in women about 10 years later than it does in men.

What can women do to maximize a heart-healthy lifestyle?

Dr. Smith: Science and our instincts are converging on this one. We now have convincing evidence that people who use their hearts have a much lower risk of death. So it’s a good idea to start regular aerobic exercise. Even a walking program can help a lot. The goal should be to get short of breath for 30 minutes five days a week. You should try to exert enough energy each week so that you can’t whistle or sing for 150 minutes. That reduces your risk of death by 20 percent!

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