Cardiovascular disease is the leading cause of death for women in the United States, causing 1 in 3 deaths each year.
While many people think of crushing chest pain as a primary symptom of a heart attack, women are more likely to experience nausea, sweating, fatigue and shortness of breath, which can be accompanied by pain in the upper back.
“Women often write off their symptoms as something else,” she says. “If they experience severe fatigue, they tend to rationalize it—‘I’m a mother, I work a full-time job, I’m taking care of my elderly parents, of course I’m tired.’"
She describes their complaints as "pain in the arm or shoulder blade, or a burning sensation in the throat, but they don’t typically experience the ‘elephant sitting on my chest’ feeling that men more often have.”
Furthermore, Ray points out that some of the symptoms of menopause mimic those of a heart attack.
Women are more likely to experience nausea, profuse sweating and fatigue, perhaps accompanied by pain in the upper back.
“Fatigue, hot flashes, and night sweats are all common complaints of women going through menopause, but they can also be signs of heart problems,” she notes. “Women often dismiss heart symptoms as menopause-related, stress or even panic attacks.”
Why Recognizing Symptoms is Essential
Recognizing these symptoms is crucial, because there are several misconceptions about heart disease in women that could be putting them at risk.
“More women die from heart disease than from all types of cancer combined,” Ray emphasizes. “And women are more likely than men to not survive their first heart attack.”
This is attributed to multiple factors:
- Women tend to develop heart disease later in life, so they’re likely to have other medical issues and not be as healthy
- Women wait longer to seek medical attention
- Women’s arteries tend to be smaller than men’s and can become blocked with plaque more easily
- Women’s risk of coronary artery disease increases dramatically after menopause
- Female hormones have a protective effect that disappears as women age
Know Your Risk
The first step women can take in reducing their risk of having a heart attack is to educate themselves.
“Know the risk factors and know if you have those risk factors, including family medical history," says Ray. "Seek medical attention if you have symptoms, and take the steps to lessen any of the risk factors that can be modified.”
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Primary risk factors include:
- High blood pressure
- High cholesterol (especially when paired with low levels of HDL)
- Lack of exercise
- Age 50+ and/or post-menopausal
- History of heart problems in parents or siblings
Prior medical conditions can also be risk factors. For example, women who have undergone treatment for breast cancer are at a higher risk of developing heart disease. Radiation can cause hardening of the arteries and blood clots, and common chemotherapy drugs such as Herceptin (trastuzumab) and anthracycline can increase the risk of heart problems. HPV (human papilloma virus), better known for causing genital warts and most types of cervical cancer, is also linked to a higher rate of future heart disease.
Some risk factors aren’t modifiable—such as age, family history, and ethnic origin; but others are within your control: blood pressure, cholesterol, alcohol and tobacco use, and exercise.
“Don’t ignore your symptoms, especially if you experience shortness of breath or fatigue after doing activities that haven’t affected you before, such as going up a flight of stairs or carrying groceries,” says Ray. “Women present differently than men based on risk factors and it’s better to get checked out early than to ignore and put yourself at risk. Heart disease is preventable.”