It’s been in the news. It’s been presented at cardiology conferences. It has set cardiac circles and women heart attack survivors abuzz. It’s the question of whether women present with heart attack symptoms that are different than those of men. The media attention surrounding the claims of this study conclusion has put women’s awareness of heart disease back a decade, in my opinion.
For clarification, let’s visit the website of the world-famous Mayo Clinic:
“What are the symptoms of a heart attack for women?”
“The most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the chest. But it’s not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have signs and symptoms unrelated to chest pain, such as:
- Neck, shoulder, jaw, upper back or abdominal discomfort
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or dizziness
- Unusual fatigue
- A profound “sense of impending doom”
“These signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks. ”
NOTE: 8-10% of women report no chest symptoms at all during a heart attack.(1) This may be because women tend to have blockages not only in their main coronary arteries, but also in the smaller arteries that supply blood to the heart — a condition called small vessel or coronary microvascular disease or MVD.
“Many women tend to show up in emergency rooms after much heart damage has already occurred because their symptoms are not those typically associated with a heart attack.
“If you experience these symptoms or think you’re having a heart attack, call 911 for emergency medical help immediately. Don’t drive yourself to the emergency room. Chew one full-strength uncoated aspirin.”
UPDATE: When I asked cardiologist Dr. Sharonne Hayes, founder of the Mayo Women’s Heart Clinic, about this issue, she suggested that, due to physicians’ unconscious bias about women being at risk, “women are less likely to be asked about their chest pain, so the symptom is just not recorded, and diagnosis can be delayed.”
“Chest pain is still overwhelmingly the most common symptom in both men and women. Among those women without chest pain, there are some subtle differences: women were more likely to present with atypical symptoms including jaw pain and nausea or vomiting.”
Find out more about women’s heart disease from Mayo Clinic.
(1) S. Dey et al, “GRACE: Acute coronary syndromes: Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes: the Global Registry of Acute Coronary Events”, Heart 2009;95:1 20–26.
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