Six Heart Facts Every Woman Should Know

For years, cardiologists advised women about their heart health with data and guidelines that were established from mostly male studies. This, we've discovered, meant misdiagnosing women and treating them incompletely, ineffectively, or too late. The bottom line is this: When it comes to taking care of your heart, men and women are different. What works for men often doesn't work for women. Here's what you need to know:

1. Women's symptoms are subtler.

Men often have dramatic onset, such as numbness or a sharp pain in the middle, left, or right side of the chest.

Women's early warning symptoms often appear to be only anxiety, stress, or indigestion. Signs of coronary insufficiency include discomfort in the chest, waking up at night with difficulty catching breath; chronic generalized fatigue; a pain below the left shoulder blade or elsewhere in the back; pain or tingling in jaw, elbow, or arm; a pain in the left arm simultaneous with chest pain; throat tightness; shortness of breath; gastro-intestinal problems accompanied by a feeling of fullness and wanting to burp; nausea and vomiting; lightheadedness, dizziness, or vertigo with exertion; disproportionate sweating with activity; angina; or heart attack.

2. Women tend to develop heart problems later in life, but with worse impact.

 Males statistically have heart-related problems ten years earlier than women, but are more able to recover. Women, as they age, experience a greater rise in cholesterol levels, high blood pressure, weight gain, and menopausal hormone imbalance. Conditions tend to be more serious at the onset, but can often mimic arthritis and other age-related maladies.

3. Women are protected during the childbearing years.

 Men often carry a great deal of work-related stress during their prime years, which can add to their risk. During their childbearing years, women have high estrogen levels which lower LDL ("bad") cholesterol levels and raise HDL ("good") cholesterol. After menopause, as estrogen drops, LDL goes up and HDL goes down. Countering this advantage is the fact that birth control pills increase the risk of heart problems during this same stage of life, especially in combination with smoking. Because women have learned to bear pain in the form of menstrual cramps, pregnancy, and childbirth, they may also be prone to denial where heart pain is concerned.

4. The female heart is constructed differently.

 Men's hearts are larger, with more powerful muscles, used to bearing a sudden increase in workload. Women's' hearts are smaller, and the arteries are narrower. Because the inside diameter of the arteries is narrower, they can be blocked more easily by a buildup of plaque.

5. Men can experience angina, but it is a different phenomenon.

Men's angina comes on with exercise or exertion, and improves with rest. Women's angina comes and goes with no obvious cause, and may not improve with rest. Women's angina is often mistaken for gastrointestinal problems. Women experience chronic lower-grade angina symptoms rather than sudden dramatic signs like men.

6. Heart problems are more than medical for women.

Women are more likely to generalize stress and unhappiness as heart problems, but also more intuitive about diagnosing the problem. For men, heart problems may present themselves in fairly mechanical terms, making it possible to treat the symptoms as they appear.

For women, heart problems are often more than purely medical problems. They are often problems of the heart, of the fullness of their emotional life. Preventive medicine, watching for subtle signs, staying on top of overall "quality of life" issues, is the best medicine. Fortunately, women have a much better ability to intuit what the problems are and speak about them, and are much more likely to go to heart workshops, therapy, or discussion groups in order to accelerate the healing process.

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