Women’s heart pain is both physical and emotional

by Carolyn Thomas    ♥  @HeartSisters

Before a heart attack actually occurs, people suffering from the chest pain of angina can feel emotionally traumatized.  Angina may be a physical cardiovascular problem, but it can also take a remarkable emotional toll in the form of anxiety or depression. 

Imagine living in constant dread of the next painful attack, or feeling distressed because angina has forced you to give up activities you enjoy. Over time, anxiety and depression may become a part of your ongoing cardiac symptoms along with the alarming chest pain that can come with an angina attack.  This can lead to a vicious cycle: depression, anxiety, and stress may actually trigger angina pain by prompting the release of hormones that make the heart work harder.

In general, women are about twice as likely as men to be depressed, regardless of race, ethnicity or socio-economic background. But women with a history of angina are 57% more likely to suffer from depression than women without any history of heart disease. 

According to Mayo Clinic cardiologists, the chest pain and discomfort common with angina may be described as pressure, squeezing, fullness or pain in the center of your chest. Some people with angina symptoms describe angina as feeling like a vise is squeezing their chest, or feeling like a heavy weight has been placed on their chest.

But a woman’s angina symptoms can be different from the classic angina symptoms.

For example, a woman may have chest pain that feels like a stabbing, pulsating, sharp form of chest pain or heaviness, fullness and pressure rather than the more typical vise-like torture we image with the classic Hollywood Heart Attack seen in the media (which is actually more likely sudden cardiac arrest, not a heart attack. Women are also more likely to experience symptoms, such as nausea, vomiting, shortness of breath, crushing fatigue or abdominal pain. These differences may lead to delays in seeking treatment.

The severity, duration and type of angina can vary. It’s important to recognize if you have new or changing chest pain. New or different symptoms may signal a more dangerous form of angina (unstable angina) or an imminent heart attack.

Stable angina, on the other hand, is the most common form of angina. When I was at Mayo Clinic after my own heart attack, cardiologists there described stable angina as any symptoms between neck and navel that typically come on with exertion and go away with rest.

But if chest pain is a new symptom for you, it’s important to see your doctor to find out what’s causing your chest pain and to get proper treatment. If your stable angina gets worse or changes, seek medical attention immediately.

Here are some general examples of angina symptoms from Mayo Clinic:

Characteristics of stable angina

• Develops when your heart works harder, such as when you exercise or climb stairs
• Can usually be predicted and the pain is usually similar to previous types of chest pain you’ve had
• Lasts a short time, perhaps five minutes or less
• Disappears sooner if you rest or use your angina medication
• Could feel like indigestion
• Might spread to your arms, back or other areas
• Can be triggered by mental or emotional stress

Characteristics of unstable angina (a medical emergency!)

• Occurs even at rest
• Is a change in your usual pattern of angina
• Is unexpected
• Is usually more severe and lasts longer than stable angina, maybe as long as 30 minutes
• May not disappear with rest or use of angina medication
• Might signal a heart attack

Characteristics of variant angina (Prinzmetal’s variant angina)

• Usually happens when you’re resting
• Is often severe
• May be relieved by angina medication

Prinzmetal’s angina is relatively rare — only about 2 percent of angina cases are Prinzmetal’s. This type of angina is caused by a spasm in your heart’s arteries that temporarily reduces blood flow to the heart muscle.

© 2009 Carolyn Thomas   www.myheartsisters.org

See also:

• Misdiagnosed: women’s coronary microvascular and spasm pain
• Coronary Microvascular Disease: a “trash basket diagnosis”?
• What is causing my chest pain?
• The chest pain of angina comes in four flavours
• The freakish nature of cardiac pain

Q: How have the symptoms of angina affected your life?