Heart disease affects men and women differently — do you know the signs?

·5 min read

Heart disease is the leading cause of death among men and women in the U.S. In fact, heart disease claims more lives each year than all forms of cancer combined. But what you may not realize is that there are some big differences in the way men and women experience heart disease. And doctors say knowing and understanding those differences could help save your life.

Here are three key differences you should be aware of.

#1 Risk factors

Whether you’re a man or a woman, there are several risk factors for heart disease that impact both sexes equally. Among those are tobacco use, diabetes, high cholesterol, high blood pressure, obesity and lack of physical activity. But for women, doctors say there are additional risk factors and warning signs to watch out for.

Dr. Sheila Sahni, an interventional cardiologist and the director of the women’s heart program at Sahni Heart Center in Clark, New Jersey, tells Yahoo Life, “Factors unique to women include autoimmune conditions, such as lupus and rheumatoid arthritis, a history of breast cancer and having received chemotherapy or radiation therapy to the chest, as well as psychiatric issues such as depression, anxiety, and other forms of mental illness.”

Sahni also says pregnancy can serve as a woman’s first cardiac stress test. “Conditions such as gestational diabetes, high blood pressure, preeclampsia – if you had them when you were pregnant, they can actually affect your chances of developing heart disease long after your pregnancy is over.”

#2 Signs and symptoms

Because women were excluded from early heart disease studies, many of our ideas about what a heart attack victim looks like come from the male perspective. “When men present with heart attacks, they tend to present similar to how we've seen it depicted in Hollywood – crushing chest pain in the center of their chest or their jaw clenching,” explains Sahni. “But when it comes to a woman, the signs and symptoms can be a lot more subtle.”

Women experiencing a heart attack may feel a shortness of breath, fatigue, nausea or even heartburn. These less dramatic symptoms cause women to wait more than 30 percent longer than men before they head to the hospital. And once there, women are less likely to be properly diagnosed. “Women come in with symptoms, and then we do a test, like an angiogram,” explains Dr. Sharonne N. Hayes, a professor of cardiovascular medicine at the Mayo Clinic and founder of the Women’s Heart Clinic. “But if the angiogram says, ‘Oh, there’s no blockages,’ we invalidate her. We say, ‘Well, it’s nothing. You’re just out of shape, you’re getting old, you’re menopausal.’”

There’s also a difference between men and women and the events leading up to a heart attack. Sahni explains, “We have found that more men report some new physical activity or physical exertion such as running or shoveling snow” before having a heart attack. “Whereas for women, there's often an emotional stressor that preceded their heart attack, such as some very devastating news, the death of a family member, or even a divorce,” she says.

Sahni advises women that “any new symptom between the navel and the nose that comes on with exertion, whether physical or emotional, and goes away with rest, needs to get checked out right away by a doctor.”

#3 Causes and effects

The reason why heart attacks in men tend to be more dramatic can be attributed to what’s going on inside the body. Sahni says male heart attack patients typically suffer a full blockage within the heart’s blood vessels, abruptly stopping the flow of blood to the heart. In contrast, when a woman has a heart attack, it often stems from a slow deterioration of the arteries. “So if you imagine a scenario of pipes, if a pipe is fully clogged, that creates a dramatic backup,” says Sahni. “But if a pipe slowly erodes over time, the presentation might be more subtle.”

Another type of heart attack more common in women is spontaneous coronary artery dissection, or SCAD. This condition causes a tearing in the coronary artery wall that can trap blood and block arteries. Hayes says SCAD is the number one cause of heart attacks in women under the age of 40, but the research is so new, some women are still falling through the cracks. “So when that 40-year-old, healthy looking woman with SCAD goes in literally saying, ‘I feel like there’s an elephant on my chest. I have pain going down my arm. I’m short of breath and I’m sweating,’ they get told it’s a panic attack.”

Until studies and clinical trials catch up, Hayes advises women to trust their gut. “They may have to push a little bit harder or assert themselves a bit more and tell themselves that they know their body best. They often are not just their best advocate, but their only advocate.”

But no matter what your gender is, Sahni says knowing your risk factors, signs and symptoms is key to staying heart healthy. “Knowledge is power,” says Sahni. “Educate yourself so you can be your own heart hero and prevent heart disease in your own life.”

Video produced by Jacquie Cosgrove

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