A few weeks ago my friend went to the doctor because of transient pain and shortness of breath. She was hospitalized for a few days, and thank God, all tests came back normal. The doctors explained that they are extra cautious with women because their symptoms of heart disease are atypical.
I met Dr. Roy Schwartz, a medical intern, on Twitter (@diseaseaday) through my obsession with interest in swine flu. On his blog, A Disease A Day, he describes symptoms and treatments of common ailments. Because many readers are approaching the critical age I invited him to write a guest post about women and heart attacks.
Heart Attacks – Are Men from Mars and Women from Venus? Guest Post by Dr. Roy Schwartz
The answer: YES. We are not only different in the way we look, the way we behave and all the rest. We are also different in the way we experience heart attacks.
Heart disease is a leading killer for both sexes. But what are the differences and why do they exist? We’ll cover some of the major ones here.
- Risk age
The facts: Men start to be more prone to heart attacks when they are 45, women at 55.
The reason: Menopause. After menopause levels of HDL cholesterol (“good” cholesterol) fall and levels of LDL cholesterol (the “bad” one) rise, increasing women’s risk.
Will hormone replacement therapy (HRT) reduce your risk of heart attack? Unfortunately, no. Studies have found that HRT actually INCREASES the risk of heart attacks, stroke and breast cancer.
The facts: Women experience heart attacks differently. Heart attacks begin with angina pectoris, the chest pain caused by clogged arteries in the heart. While in men this pain is more “typical” (in the center of the chest; radiating to the neck, jaw or arm; occurring after exertion), in women it may appear in different locations and not be related to any activity. The pain of angina in women may come and go over days, weeks, or months. It may be seasonal— becoming more frequent in the winter in temperate climates. It may not appear as pain at all, but as difficulty breathing, nausea, fatigue or abdominal pain.
All of these differences make the diagnosis of heart attacks in women more problematic, sometimes causing a delay in diagnosis.
The reason: No one really knows.
The facts: Women tend to avoid or delay seeking medical care when they face heart attacks or angina.
The reason: This might be partly due to denial or lack of awareness, and partly because, as stated above, symptoms tend to be “atypical.” [MiI: My friend resisted going to the hospital because she had "too many things to do."]
The facts: Some diagnostic tests and procedures may not be as accurate in women as they are in men, so physicians may not order them. This can lead to later detection of the disease.
The reason: Again, unknown.
Fact: In the past, most research studies in this area were conducted on men. This has led to a poorer understanding of the differences between men and women (and hence the “unknowns” above).