New River Medical Center

Heart Attack Symptoms Differ for Women and Men

Everyone knows a classic sign of a heart attack - the searing pain in the chest, usually lasting several minutes. Right?

Well, you would be half right because that is not necessarily the symptom felt by women, who make up 50 percent of America's heart attack victims.

And with February designated American Heart Month, physicians and medical experts hope to educate women about the nature of heart disease and how it affects them.

"Women more often than men experience shortness of breath, unusual fatigue, or the pressure is lower down in the chest so it is mistaken for a stomach ailment," says Dr. Nieca Goldberg, a cardiologist with Lenox Hill Hospital in New York City and author of Women Are Not Small M en.

In fact, many aspects of heart disease are different for women than men - its onset, its progression, and its symptoms.

Bringing Attention to Women's Hearts

Heart disease is the number one killer of both women and men, according to the National Institutes of Health (NIH).

But women are less likely than men to believe they are having a heart attack and more likely to delay seeking emergency treatment.

One big reason may be because most women do not experience that classic chest pain, according to a recent study by the College of Nursing at the University of Arkansas for Medical Science.

Researchers polled 515 women who had recently had a heart attack regarding their symptoms, and found that less than 30 percent complained of chest discomfort.

The most frequent acute symptoms were shortness of breath (58 percent), weakness (55 percent), and fatigue (43 percent).

Women also complained of sleep disturbances, back pain, indigestion, and anxiety, the survey found.

"Women should be aware of these symptoms, so they can go get help," explains Dr. Goldberg. "Women are very in tune to their bodies. When they feel different, they should go in and get checked out."

The time frame for greatest heart attack risk for women also is different than men. Women tend to be about 10 years older than men when they have a heart attack, states the NIH.

The typical male profile involves a 50-year-old man with devastating chest pain. But for women, menopause is the time when they enter their danger zone.

"Women, when they enter menopause, they have a much greater risk of high blood pressure and a much greater risk of high bad cholesterol," says Dr. Richard Stein, director of preventive cardiology at Beth Israel Hospital in New York City.

Physicians believe this could be due to the falling estrogen and progesterone levels that women experience during menopause, notes Dr. Stein.

But studies have shown that hormone-replacement therapy actually increases heart attack risk for women rather than lowering it, he says.

"The typical time for a woman to have a heart attack is about 10 years after menopause," says Dr. Goldberg, placing it around age 60.

Looking at Risk Factors

Women also tend to exhibit more risk factors for heart disease than men, remarks Dr. Goldberg.

These factors include diabetes, smoking, lack of exercise, and obesity.

"Two-thirds of women who have their first heart attack die suddenly," says Dr. Goldberg. "They have complications because they come into the healthcare system late. Women as a whole tend to take care of everyone but themselves."

To head off heart disease, postmenopausal women should undergo regular blood pressure and cholesterol checks - and do them with greater frequency than men do, says Dr. Stein.

For example, a man at risk of a heart attack should have his blood pressure checked once a year.

But because women's heart attack risk increases so dramatically following menopause, Dr. Stein recommends they have their blood pressure tested at least twice a year and their cholesterol tested at least once a year.

Women also should pay attention to how they feel when exerting themselves, Dr. Goldberg says.

"When the situation gets more serious, the person will get symptoms with less and less exertion, or even at rest," she says. "So that's a big clue. Six weeks before they have an actual heart attack, they will have exertion symptoms."

Women should also cut back on smoking and drinking, and watch their diet, notes Dr. Stein.

Regular aerobic exercise and a high-fiber, low-fat diet can be the two best ways to head off a heart attack, he says.

"Diet and exercise are critical parts of prevention for women," Dr. Stein says.

And women cannot start taking care of themselves soon enough, says Dr. Goldberg.

"We can actually see the earliest buildup of plaque in a woman's late teens and 20s," she says. "The groundwork starts early. It's important to adapt to a healthy lifestyle when you're young."

Always consult your physician for more information.