Dossier: Healthy heart

Heart attacks: symptoms in women

Women march to a different beat – at least when it comes to their health. Although women are biologically better protected against heart attacks until menopause, they're more likely to die from one than men. This is often because the symptoms are misinterpreted.

Text: Katharina Rilling; Image: Gantas Vaioriulnas / Unsplash

A stove in the chest, bright pain in the left Arm, This is what he believes, the classic heart attack – the man. However, it's less known how a heart attack affects female sex, but it is less known. Heart attacks are even their main cause of death in our broad grass, not – as you could accept – the breast cancer “, says cardiologist Belinda Nazan Walpothy, who heads the specialist” Ms and Heart ”at the Inselspital in Bern.

It is that women are very rarely able to be able to be sick. Even in the heads of some medical colleagues and colleagues, it hasn 't yet been reached. A similar image of the Sanitas Health Forecast 2020: A quarter of men is interested in improving their cardiovascular stability – women are only 16% .

She gives a  classic example of a woman in her fifties, slightly overweight and with elevated cholesterol levels: "She registered with her family doctor in the cold season. She said to be tired and to be exhausted to lift your arms. She was advised on the phone to rest. She didn’t have a temperature, so was told to get back in touch if her condition worsened. Two hours later, the woman turned up at the doctor’s practice because she was so worried about how fatigued she was. And it turns out she’d had a heart attack! She was sent straight to hospital, where the blocked blood vessel was opened. I saw her three months later for a follow-up check. She told me she'd never expected to have a heart attack.”'

Symptoms: What are the signs of heart disease?

The problem is that the warning signs are often difficult to identify in women. And the first hours are critical for anyone having a heart attack. “You should open up the closed vessel very quickly to prevent tissue loss,” says the heart specialist.

If women don’t have the “classic” signs, such as a chest pain or radiating pain in the left arm, they often play down or misinterpret their symptoms. Caution is advised when a woman experiences sudden fatigue, problems sleeping, shortness of breath and digestive problems, numbness in the arms and/or pain in the back or legs.

These symptoms may initially sound harmless, but they can be a warning sign of a heart attack days or weeks in advance. Too often they are put down to a cold, muscle pain, the menopause or stress. But you’re unlikely to go to the doctor due to tiredness and stomach pains. “Women with abdominal pain, sudden shortness of breath and fatigue are better advised to go to hospital once too often, especially if they have diabetes or metabolic syndrome, i.e. high cholesterol levels, if they are overweight, have high blood pressure or borderline sugar levels,” says Dr Walpoth.

Women usually present with different symptoms than men when they have a heart attack:

  • Breathing difficulties/shortness of breath
  • ● Unexplained nausea and vomiting
  • ● Pressure in the chest, back or (upper) belly
  • Pain in jaw and throat
  • Fatigue

However, according to the Swiss Heart Foundation, women can also suffer the “classic” symptoms:

  • ● Severe pressure and tight, constricting or burning pain in the chest (lasting longer than 15 minutes), often associated with shortness of breath and fear of death
  • ● Sometimes (!) radiation of the pain throughout the chest, through to both shoulders, arms, neck, lower jaw or upper abdomen.
  • Possible symptoms are low, light face colour, nausea, weakness, sweating, shortness of breath, irregular heart rate, the pain is independent of physical movements or breathing and not even after taking the medication.

Risk factors for heart disease in women

Where men already from the age of 50 As a result of a heart attack, a heart attack is often increased for women aged ten years later. This goes someway to explaining the higher mortality rate for women after a heart attack even with the same treatment: As you get older, the risk of a fatal discharge increases. It's believed that female hormones provide biological protection that starts to wear off after menopause.

“I advise women to have their risk profile assessed by their family doctor at the very latest once the menupause sets in. Cholesterol? Cholesterol? Blood sugar? Blood pressure? Weight? Nicotine? Family history?. In fact, ideally they should go even earlier. If you belong to a risk group and don’t feel well, you should get checked out by a cardiologist," says Walpoth.

The typical risk factors are the same for men and women: High blood pressure, elevated blood lipid levels, stress, obesity, diabetes and smoking are all harmful to the heart. However, many factors have a bigger impact on the female body.

For example, the risk of heart disease is much higher in women with diabetes than in men. And women’s hearts seems to react worse to cigarette smoke, The danger to heart attacks is 25% higher for smokers than smoking. If the smoking pill persists, this increases the probability of blood cells. Permanent stress and depression are also more damaging to women’s heart health than men’s. The same is also true of even small amounts of alcohol.

Women also have a host of other risk factors, such as unusually early menstruation (under the age of 10), early menopause and pregnancy complications such as pre-eclampsia and eclampsia. Dr Walpoth also says: “Women today often struggle to juggle family and work, and we know that stress is a big risk factor for women.”

Prevention and treatment: what helps your heart help?

a healthy lifestyle is also good for your heart. Ideally, you should eat a balanced diet, get regular exercise, try to avoid stress, maintain an ideal weight, not smoke and not drink too much alcohol. It’s also a good idea to get your blood pressure, cholesterol and blood sugar checked regularly. “My top tip is to take preventive measures against risk factors, have preventive medical check-ups and – if medication is necessary – to make sure you take it.”

For a long time, women were given the same treatment as small men. However, it’s not only the lower bodyweight that means women respond differently than man to many medicines. Their blood vessels are also different. "Gender medicine enables us to address and raise awareness of women-specific aspects in the prevention, diagnosis and treatment of cardiovascular diseases,” says Dr Walpoth. “The awareness that women’s hearts beat differently and need a different treatment is vital.”

Heart facts

  • The heart is a muscle about the size of a fist. It weighs around 250 g for women and 300 g for men.
  • Around 30,000 people in Switzerland suffer an acute coronary event (heart attack/angina)
  • Heart attacks are the number one cause of death worldwide.
  • Four out of five heart emergencies occur outside the hospital.
  • People who have a heart attack are admitted to hospital with an average delay of three hours from the onset of symptoms.
  • Women suffer from cardiac insufficiency more often than men. Persistent fatigue and swollen ankles are often attributed to age, but can also be a sign of the disease.

Heart disease is roughly as common in women as in men.