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May 2024

Heart Disease Can Be Trickier in Women

Heart disease trumps all other diseases, including cancer, as the number one cause of death for American women. That's partly because women may suffer from less recognizable heart attack symptoms. The condition may also affect a woman’s body differently, making it harder to recognize.

Not your ‘typical’ heart attack

Women—more than men—tend to experience non-traditional symptoms of a heart attack. In fact, women don’t always have the telltale symptom of severe chest pain or pressure. Rather, they are more likely to feel jaw or neck pain. They may also experience the following:

  • Shortness of breath

  • Indigestion

  • Heartburn

  • Upper back pain

  • Extreme fatigue

These subtler symptoms may lead some women to dismiss the thought of a heart attack. Doctors may also mistake these signs for another condition.

Different types of heart disease

Along with uncommon heart attack symptoms, the type of heart disease affecting a woman can make for a more difficult diagnosis. Doctors use the term heart disease as a catchall for many types of conditions affecting the heart. The most common is coronary heart disease (CHD). It affects both men and women. In CHD, plaque builds up in the large arteries, which may lead to a heart attack.

More women, though, tend to have a less commonly known condition called coronary microvascular disease (CMD). CMD is when the inner walls of the smallest arteries spasm. The spasms can reduce blood flow to the heart muscle. Researchers think women are more prone to CMD because of a drop in estrogen before menopause. Typical tests used to diagnose CHD, such as the stress test or angiogram, may not be as effective in finding CMD. They aren’t sensitive enough yet to detect damage in the tiny arteries, possibly leading to a misdiagnosis.

Doctors are working hard to find the best way to diagnose all types of heart disease in women, including CMD. You can do your part, too. Live heart-healthy. And know all the potential signs of a heart attack. Seek help immediately if you think you may be having a heart attack. Even a slight delay in diagnosis and treatment may mean the difference between life and death.

Online Medical Reviewer: Brian McDonough, MD
Online Medical Reviewer: Stacey Wojcik, MBA, BSN, RN
Date Last Reviewed: 3/1/2024
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