Why It’s Important to Understand That Men and Women Have Heart Attacks in Different Ways

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February is American Heart Month. While medicine has made large strides in treating heart disease, a heart attack is still the number one cause of death in the country. Putting a focus on heart health during the month provides an opportunity to learn more about how to prevent heart attacks and what happens to our bodies when a heart attack occurs. It is a different process for women than men.

According to mayoclinic.com. “A heart attack occurs when the flow of blood to the heart is severely reduced or blocked. The blockage is usually due to a buildup of fat, cholesterol and other substances in the … coronary arteries. The fatty, cholesterol-containing deposits are called plaques. The process of plaque buildup is called atherosclerosis…Sometimes, a plaque can rupture and form a clot that blocks blood flow. A lack of blood flow can damage or destroy part of the heart muscle.” It is the obstructed blood flow that is occurring when having a heart attack.

The Mayo Clinic goes on to say that some heart attacks strike suddenly. However, many people have warning signs and symptoms hours, days or weeks in advance. Chest pain or pressure that keeps happening and doesn’t go away with rest may be an early warning sign. This is caused by a temporary decrease in blood flow to the heart from bits of plaque or some other event blocking blood flow.

Heart attacks can be sneaky. They do not always happen in the classic way with chest pain and/or pain shooting down the left arm. Symptoms are different for everyone. Heart attacks in women are different and deadlier because of how they manifest. Women are more likely to experience symptoms such as nausea or vomiting, shortness of breath and back or jaw pain, according to an article in The Washington Post. If these symptoms don’t go away with rest, then a woman should treat it as if she is experiencing a heart attack.

Until recently, most research on heart disease has focused on men, and assumed that women had the same experience during a heart attack, according to an article in tm-women.org.  In the article, Dr. Abraham Bornstein, Board-Certified Cardiologist and Fellow of The New York Academy of Medicine in the Division of Evidence-Based Medicine, speaks of several studies comparing the chance of death from a heart attack between women and men. These studies show that women are three to four times more likely to die from a heart attack due to improper diagnosis and treatment.

Dr. Bornstein went on to explain that how women experience blood deficiency, known as ischemia, is different from how a man experiences it. “…[I]schemia is a deficiency in the supply of blood to the heart due to obstruction in the large arteries (usually seem more in men) and spasm in the small arteries (usually seen more in women), often experienced as chest pains (differently in men and women).”

Plaque also forms differently in the sexes. “Specifically, … men’s cholesterol plaque distributes in clumps which cause significant arterial obstruction. In contrast, women’s plaque distributes evenly, without necessarily clumping, throughout the artery walls. As to ischemia, women have a higher prevalence of both anginal and atypical chest pains than do men. When women’s heart disease was tested by X-ray, CT scan, ECG or MRI, the tests were misinterpreted as normal when they were actually not normal.”

As much as a month prior to a heart attack, a woman may experience symptoms such as unusual fatigue, sleep disturbance, shortness of breath, indigestion, anxiety, racing heart and weakness in the arms.

The entertainment media usually shows a heart attack as a soreness in the arm and then a piercing pain in the chest, but not so in women. Female symptoms, tm-women.org goes on to explain, include an uncomfortable pressure, squeezing, fullness or pain in the center of the chest that may last more than a few minutes, or goes away and comes back; pain or discomfort in one or both arms, the back, neck, jaw or stomach; shortness of breath with or without chest discomfort; and/or breaking out in a cold sweat and/or having nausea or lightheadedness.

WebMD.com notes, “Black women of any age have a higher incidence of heart attacks than white women. And black and Hispanic women have more risk factors such as obesity, diabetes and high blood pressure at the time of heart attack compared to white women.”

Dr. Laxmi Mehta, Director of the Women’s Cardiovascular Health Program at Ohio State University Medical Center, stresses in the WebMD article that women need to “know their numbers” — including blood pressure, cholesterol, blood glucose, body mass index (BMI, a ratio of weight to height) and waist circumference. Then they need to take action to keep these numbers in the normal ranges.

“Lead an active, healthy lifestyle and be accountable for your decisions,” Mehta added. “This includes exercising on a regular basis, following a healthy diet and not smoking.”

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