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Living Well

Heart Attacks Look Different in Men and Women

Last updated: May 09, 2016

Everyone knows the classic heart attack scenario—an older man grabs the left side of his chest, gasps for air, and falls to the ground in pain. Some cardiac episodes manifest like this, but in reality the signs are usually less sudden and dramatic. Symptoms that appear less serious and somewhat vague often occur in women, who experience heart attacks very differently than men.  

“Many people do not know that heart disease is the number one killer of both men and women in the United States,” says Seth Jawetz, MD, a cardiologist at Summit Medical Group. “What is even less understood is that the signs of cardiac distress are different in both men and women.” 

Every 43 seconds someone has a heart attack in the United States. Many of these episodes are caused by a condition known as coronary artery disease, which causes fatty deposits of plaque to build up and clog the artery walls. The arteries are a system of tubes that transport blood, oxygen, and other essential nutrients from the heart to the rest of the body. When blood does not flow freely, the heart muscle can become damaged. The Live Well Heart Failure Clinic at Summit Medical Group partners with patients who are at risk for, or have already experienced, heart attacks to strengthen the heart muscles and help improve their tolerance for activity.

“Heart disease is often overlooked in women, because they present with more atypical symptoms than men,” explains Dr. Jawetz who notes that half of his patients are women. “This is concerning because early intervention is critical during a heart attack. Heart and vascular disease is responsible for 1 in 3 deaths in women each year, but that number should be much lower.”

Heart Attack Warning Signs 

Men are more likely to experience the classic heart attack symptoms including chest pains, shortness of breath, sweating, and vomiting. Women, however, typically do not experience chest pressure. Their symptoms tend to be more ambiguous, including extreme fatigue, anxiety, sweating, nausea, or pain in the shoulder, upper back, or neck. Women are also at an increased risk for heart disease about ten years later than men, around age 55.   

“Women experiencing a heart attack often present with a more confusing picture, including atypical pains like abdominal discomfort or nausea. As a result, many people attribute the symptoms to less serious conditions, such as a cold, anxiety, or indigestion,” says Dr. Jawetz. “I always urge clinicians to listen carefully to the patient and remember that heart disease can manifest in different ways.” 

Furthermore, Dr. Jawetz says that patients may experience more subtle symptoms of pain or discomfort for several days to weeks prior to experiencing a true heart attack.  “Patients will often describe different types of pains, such as a burning or stabbing sensation. Sometimes they can’t really describe the feeling, but they know something is not right,” he says. Many people also confuse this type of chest discomfort for muscle pain. 

Why Heart Attacks Occur 

Heart attacks occur when an artery becomes severely or completely blocked. If you are experiencing a heart attack, the symptoms will not go away or get better when you rest or change position. Call 9-1-1 immediately or have a family member drive you to the closest emergency room.  

Patients that present with a heart attack usually require a minimally invasive surgical procedure known as an angioplasty to open up the artery wall. “We generally want to open up the affected artery as quickly as possible to prevent irreversible damage, which could lead to congestive heart failure,” says Dr. Jawetz. 

Other patients have arteries that are only partially blocked, allowing some flow of blood and oxygen to the heart muscle. These attacks can be even more confusing because the symptoms tend to go away and come back. “If the clot changes—it gets slightly better or worse—then the patient’s symptoms may wax and wane,” explains Dr. Jawetz. 

Women, in particular, can also experience silent heart attacks, which have either no or very minimal symptoms. During these events, an artery becomes sufficiently blocked and there is a brief loss of oxygen to the heart muscle. While temporary, these attacks can still cause damage and potentially lead to heart failure. 

Undiagnosed Heart Attacks Can Lead to Heart Failure 

“Sometimes, people do not realize that they had a heart attack and present with symptoms of heart failure at a later date,” explains Dr. Jawetz. “At that point the attack has already affected their heart function to the point where they are short of breath due to fluid build-up in the lungs or have swollen legs.” 

One of the most concerning signs of heart failure for both men and women is shortness of breath or fatigue that seems out of the ordinary. “If you are an active person who can exercise for 30 minutes on a treadmill or elliptical trainer and suddenly there is marked change in your exercise tolerance, you should come in for an evaluation,” says Dr. Jawetz. 

Certain men and women have a higher chance of developing a heart attack. Risk factors include: a family history of heart disease, obesity, high blood pressure, high cholesterol, smoking, and diabetes. Dr. Jawetz advises his patients to discuss any potential signs of heart disease with their primary care physician. 

For more information on The Live Well Heart Failure Clinic at Summit Medical Group, please call 908-277-8700.

Sources

1. Interview with Seth Jawetz, MD 
2. Centers for Disease Control and Prevention http://www.cdc.gov/heartdisease/heart_attack.htm
3. American Heart Association – Go Red for Women 
https://www.goredforwomen.org/

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