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, several warning signs 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 notice 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: Women who experience sustained high blood pressure face a greater risk of heart disease.
• African American: Black women have a much higher chance of experiencing high blood pressure compared to their White counterparts.
• Undetected: High blood pressure frequently goes undetected in women.

Medical conditions and lifestyle choices:

• Diabetes: Women with diabetes are more likely to develop heart disease than women without the condition.
• Physical inactivity: A sedentary lifestyle can contribute to heart disease risk in women.
• Smoking: Female smokers have a higher risk of heart disease compared to non-smokers.
• High cholesterol levels: Elevated cholesterol levels can lead to the buildup of plaque in arteries, increasing heart disease risk in women.
• Family history: If heart disease runs in the family, a woman's chances of experiencing the condition may be higher.
• Inflammatory illnesses: Conditions like rheumatoid arthritis can raise the risk of heart disease in women.
• Mental health: Stress and depression increase women’s risk of heart disease more than men’s.
• Obesity: Carrying extra body weight can lead to multiple risk factors for heart disease in women, including elevated blood pressure, increased cholesterol levels, and diabetes.
• Broken heart syndrome: Extremely stressful situations (such as the death of a loved one) can bring on this condition and cause heart muscle failure. While normally temporary, it can be dangerous, especially in post-menopausal women.

Reproductive health and pregnancy-related risk factors:

• Early first period: Women who begin menstruating at an early age have a higher risk.
• Early menopause: Women who experience menopause before the age of 40 are at an increased risk of heart disease.
• Preterm delivery: Giving birth before 37 weeks of pregnancy places a woman at greater risk.
• High blood pressure: The risk of future heart disease development is twice as high for pregnant women with high blood pressure. This is also known as preeclampsia.
• Gestational diabetes: The onset of diabetes while pregnant can heighten a woman's likelihood of experiencing heart disease.
• Menopause: The drop in estrogen production after menopause leaves women more vulnerable to developing heart disease.

Cardiovascular conditions during pregnancy:

• Peripartum cardiomyopathy: A rare but serious condition where the heart muscle weakens during the final months of pregnancy or shortly after delivery, leading to heart failure.
• Congestive heart failure: A medical condition marked by the heart's insufficient capacity to pump blood, causing fluid retention in the lungs and elsewhere in the body.
• Arrhythmias: Irregular heart rhythms can occur during pregnancy, with some types posing a risk to both the mother and the baby.
• Venous thromboembolism: The formation of blood clots within the deep leg veins, or deep vein thrombosis, and their potential migration to the lungs, resulting in pulmonary embolism, pose serious risks. These conditions have a higher probability of occurring during pregnancy.
• Aortic dissection: A rare but potentially fatal condition where the inner layer of the aorta tears, causing blood to flow between the layers and forcing them apart. Pregnancy can increase the risk of aortic dissection in women with certain genetic disorders or pre-existing conditions.

Prevention

Luckily, heart disease in women is a largely preventable disease. 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: Consuming foods low in saturated fats, sugars, and sodium while focusing on fiber, fruits, and vegetables can aid in preventing arterial plaque accumulation. This can ultimately decrease your heart disease risk.
• Exercising regularly: Committing to a minimum of 150 minutes of physical activity each week, or daily 30-minute sessions for five days, can lower the likelihood of developing heart disease. Aim for a mix of moderate-intensity aerobic activities, such as brisk walking, swimming, or cycling.
• Not smoking: Quitting smoking can greatly improve your heart health and reduce the risk of heart-related complications. Consider seeking support from healthcare professionals or smoking cessation programs to help you quit.
• Maintaining a healthy weight: Carrying excess weight can put strain on your heart and increase the risk of heart disease. Your healthcare provider can help determine a healthy weight range for you based on your individual needs.
• Managing stress: Chronic stress can contribute to heart disease. Integrate stress-relieving practices like meditation, yoga, or deep breathing exercises into your everyday activities.
• Limiting alcohol intake: Excessive alcohol consumption can increase your risk of heart disease. It's recommended that women limit their alcohol intake to one drink per day or less to help maintain a healthy heart.
• Controlling blood pressure: Pay close attention to your blood pressure. If it's consistently high, work with your healthcare provider to develop a treatment plan, which may include medication, lifestyle changes, or both.
• Regular check-ups and screening: Regularly visit your healthcare provider to discuss your heart health and risk factors. They can help monitor your cholesterol, blood pressure, and blood sugar levels, and recommend appropriate preventive measures based on your individual risk factors.

Diagnosis

Depending on your symptoms and your risk factors for heart disease, your Baptist Health cardiologist may recommend one or more of the following tests to help assess the health of your heart:

• Electrocardiogram (ECG/EKG): This test is used to record your heart’s electrical activity (using electrodes attached to your chest) to check for arrhythmia (irregular heart rhythm) or other abnormalities.
• Stress test: In order to determine how your heart responds to physical stress, your heart rhythms and blood pressure are monitored continuously while you are exercising — usually, walking on a treadmill.
• Echocardiogram (Echo): This test uses sound waves to create moving images of your heart to assess how well the various chambers and valves of the heart are working.
• Chest X-ray: This can be used to obtain images of your heart and lungs to look for signs of heart failure or lung problems that might point to other causes of your symptoms.
• Cardiac computed tomography (CT) scan: For this test, your doctor will inject contrast dye that will highlight your heart and blood vessels in the CT images.
• Cardiac magnetic resonance imaging (MRI): An MRI can create detailed pictures of your heart to determine whether or not you have heart disease.
• Coronary angiography and cardiac catheterization: Cardiac catheterization is used to inject dye into your coronary arteries. Then X-ray images (angiography) are taken that can reveal any blockages in the arteries.

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: These medications may help reduce the risk of heart attack by blocking the production of a chemical that narrows blood vessels.
• Anticoagulants: Often called “blood thinners,” these medications don’t technically thin the blood, but they do help prevent clots from forming.
• Antiplatelets: These also help prevent clots from forming by stopping platelets from clumping together.
• Beta blockers: These are used to slow down your heart rate, and they can help treat high blood pressure and arrhythmia.
• Calcium-channel blockers: These medications relax the blood vessels to allow blood to flow more easily to the heart.
• Digitalis: If your heart is unable to pump hard enough on its own, these medications can help it to contract harder.
• Diuretics: Also called “water pills,” these medications help reduce fluid retention in the body.
• Nitrates: These are used to relax blood vessels and help prevent chest pain.
• Statins: This group of drugs helps to lower cholesterol levels.

Procedures

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

• Angioplasty: This procedure is used to open blocked or narrowed arteries. A doctor threads a thin, flexible tube with a balloon on the end into the artery and then inflates it to open the artery. Sometimes a device called a stent is also inserted to help keep the artery open.
• Coronary artery bypass graft: Also called “bypass surgery,” this procedure takes a piece of a vein or artery from elsewhere in your body and attaches it above and below an area of blockage, creating a bypass around it.
  

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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.