Understanding Heart Disease in Women

Heart disease (also called cardiovascular disease) is the leading cause of death in the U.S., and one in four women die from it each year. And while heart disease does affect as many women as it does men, the symptoms of heart disease in women can be different. At Baptist Health, we understand that the disease often goes undiagnosed in women. That’s why we work with our patients to help them understand its causes and learn to look for signs.

Understand the early signs and symptoms of heart disease in women, as well as risk factors, prevention, and treatment methods.

At What Age Does the Risk of Heart Disease Increase in Women?

Heart disease can strike at any age, depending on a number of genetic, medical, and environmental factors. However, a women’s risk increases significantly after menopause when her body produces lower levels of estrogen. Estrogen is a known preventive for heart disease.

How Does Heart Disease Affect Women Differently Than Men?

Heart disease is the leading killer worldwide of both women and men. That said, it can affect women differently than men, thanks to small but critical differences between the male and female cardiovascular systems:

• Organ structure: Some parts of the female cardiovascular system, including heart walls, heart chambers, and blood vessels, are smaller or thinner than the male’s.
• Abrupt bodily movement: Women are more likely than men to have adverse reactions, including blood pressure spikes, to sudden shifts in body position (e.g., standing up quickly from a prone position).
• Blood count: Women have fewer blood cells than men and therefore a more limited distribution of oxygen within the body.
• Hormones: Hormone levels differ in men and women. Women have higher levels of estrogen and progesterone; men, higher levels of testosterone.

Some of these differences become apparent in the ways women experience heart disease.

What Causes Heart Disease in Women?

Medical science has identified a number of factors that increase the likelihood of heart disease in women:

• Obesity
• Hypertension (high blood pressure)
• High cholesterol
• Aging (especially in women who are post-menopausal)
• Inactive lifestyles
• A family history of heart disease
• Smoking

The risks posed by many of these factors can be reduced though behavioral change. Healthy eating, regular exercise, and smoking cessation are steps that you can take to decrease the threat of heart disease.

Common Types of Heart Disease in Women

The most prevalent heart disease in women is coronary artery disease (CAD). This occurs when blood vessels that provide oxygen and nutrients to the heart muscle become constricted or obstructed due to plaque accumulation.

Another prevalent type of heart disease that impacts women is heart failure. This occurs when the heart is incapable of pumping blood effectively enough to fulfill the body's requirements. Various factors can contribute to heart failure, such as CAD, hypertension, diabetes, and heart valve abnormalities.

Abnormal heart rhythms, also known as arrhythmias, represent another frequent type of heart disease that can affect women. There are several types of arrhythmias, with atrial fibrillation being the most common irregular heartbeat. Atrial fibrillation happens when the upper chambers of the heartbeat abnormally and lack coordination with the lower chambers. If not addressed, this condition can result in blood clots, stroke, and heart failure.

Early Signs and Symptoms of Heart Disease in Women

Detection of early heart disease signs and symptoms in women can lead to better outcomes in treatment and prevention. However, not all women will have beginning cardiac symptoms or warning signs of heart disease before an emergency arises, such as a heart attack. For those who do have heart blockage symptoms, there are several warning signs that may indicate heart disease in women. Warning signs and symptoms of heart problems in women include, but are not limited to, the following:

• Chest pain and discomfort
• Pain in neck, jaw, shoulders, or upper back
• Pain in both arms
• Indigestion
• Shortness of breath
• Sweating
• Nauseated or vomiting
• Dizziness or lightheadedness
• Unusual fatigue
• Upper abdominal pain
• General weakness
• Changes in skin color (from normal to grayish)

Symptoms of heart disease or a heart blockage tend to be more subtle in women than in men. In some cases, women do not feel much pain in the chest, and heart issues are more prone to occur in women while at rest or sleeping. This is why it is important to consult with your doctor if you have symptoms or risk factors for heart disease. Call 911 or have someone take you immediately to the ER if you are noticing any possible symptoms of a heart attack.

Women's Heart Attack Symptoms

Many women have heart attacks without realizing it because their symptoms don’t match the classic chest pain, pressure, and pain radiating down their left arms that men experience. In fact, only half of women having a heart attack experience any chest pain. Women are more likely to have some combination of the following cardiac symptoms when having a heart attack, including:

• Dizziness or feeling lightheaded
• Extreme fatigue
• Indigestion and heartburn
• Nausea and vomiting
• Difficulty breathing
• Back or neck pain

If you suspect you may be having a heart attack, call 911.

Potential Signs of Heart Blockage in Women

One of the most common forms of heart disease is coronary artery disease or CAD. CAD results from a buildup of cholesterol and fats in the blood vessels known as plaque. Plaque reduces blood flow to the heart, leading to a condition called atherosclerosis. Atherosclerosis is often a precursor to a myocardial infarction – a heart attack.

The warning signs of coronary artery disease include:

• Chest pain, also called angina
• Fatigue
• Labored breathing

Signs of Heart Failure vs. Heart Disease in Women

Heart failure is another form of heart disease. It is a chronic condition in which the heart gradually loses its ability to pump blood through the body. Heart failure occurs more often in women than men. Symptoms include:

• Edema or swelling of the limbs
• Labored breathing
• Difficulty exercising or undertaking physical activity

Risk Factors for Women's Heart Disease

Hypertension risk factors:

• Uncontrolled high blood pressure
• African American
• Undetected high blood pressure in women

Medical conditions and lifestyle choices:

• Diabetes
• Physical inactivity
• Smoking
• High cholesterol levels
• Family history
• Inflammatory illnesses
• Mental health
• Obesity
• Broken heart syndrome

Reproductive health and pregnancy-related risk factors:

• Early first period
• Early menopause
• Preterm delivery
• High blood pressure
• Gestational diabetes
• Menopause

Prevention

Leading a healthy lifestyle can greatly reduce your risk. The most important things you can do for your heart include:

• A nutritious, heart-conscious diet
• Exercising regularly
• Not smoking
• Maintaining a healthy weight
• Managing stress
• Limiting alcohol intake
• Controlling blood pressure
• Regular check-ups and screening

Diagnosis

Your Baptist Health cardiologist may recommend one or more of the following tests to help assess heart health:

• Electrocardiogram (ECG/EKG)
• Stress test
• Echocardiogram (Echo)
• Chest X-ray
• Cardiac computed tomography (CT) scan
• Cardiac magnetic resonance imaging (MRI)
• Coronary angiography and cardiac catheterization

Treatment

Your treatment will depend on your specific diagnosis and the severity of your heart disease symptoms and progression. At Baptist Health, we offer treatment options for heart disease in women including both medication and surgical or non-surgical procedures.

Medications

There are several medications that may be used to treat heart disease in women. These include:

• ACE inhibitors
• Anticoagulants
• Antiplatelets
• Beta blockers
• Calcium-channel blockers
• Digitalis
• Diuretics
• Nitrates
• Statins

Procedures

Surgical and non-surgical procedures are sometimes used to treat heart disease in women. These include:

• Angioplasty
• Coronary artery bypass graft

Why Choose Baptist Health for Your Health Care

Baptist Health is a leading health care provider in Kentucky and Southern Indiana. We offer comprehensive care through our network of medical facilities and affiliated physicians, nurses, technicians, and support personnel. Our cardiac specialists are some of the most experienced in the region.