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Women and the heart: signs of heart attack and prevention

  • Special Populations
women and heart - cardiology clinic in Puerto Vallarta.

For years, heart attack was thought of as a “man's” problem. Today we know that the heart attack in women is common, is often diagnosed late and often presents with less clear symptoms than classic oppressive chest pain.

In this guide you will see:

  • What a difference to infarction in women.
  • What are the typical and atypical symptoms.
  • Who is most at risk.
  • What you can do to prevent and when to go to the emergency room without hesitation.

This text is informative and does not replace an individual medical assessment.

What differentiates infarction in women

Some key points:

  • Heart attacks in women usually occur in the following at somewhat older ages than in men, but it also occurs in young women when there are important risk factors.
  • It is more frequent that there are several diseases at the same timeHypertension, diabetes, obesity, autoimmune diseases.
  • There are entities more common in women (e.g., spontaneous coronary artery dissection o stress cardiomyopathy) that can cause pictures very similar to a heart attack.
  • Symptoms may include less “spectacular” than severe oppressive pain, leading to delays in consultation.

Result: many women underestimate their symptoms or attribute them to “gastritis”, “stress” or “fatigue” until the condition is more severe.

Symptoms of infarction in women: typical and atypical

The “classic” symptoms of infarction can also appear in women:

  • Intense pain or tightness in the center of the chest, which may radiate to the left arm, neck, jaw or back.
  • Feeling of weight or “crushing” in the chest.
  • Significant shortness of breath.
  • Cold sweating, nausea, intense general malaise.

However, in women, the most frequent are atypical presentations, for example:

  • Pain in upper back, jaw or neck more than in the chest.
  • Chest discomfort that is less intense, but persistent or accompanied by shortness of breath, nausea or dizziness.
  • Sudden extreme fatigue (“I felt completely exhausted for no reason”).
  • Shortness of breath on usual exertion (climbing one or two floors, walking short distances).
  • Feeling of indigestion or discomfort in the “pit of the stomach”, with nausea or cold sweat.

If you have risk factors and you notice any of these signs, it is preferable to assume that it can be the heart until proven otherwise.

Risk factors for myocardial infarction in women

They share many factors with men, but some have particular weight in women:

  • Arterial hypertension, diagnosed or undiagnosed.
  • Diabetes, especially poorly controlled.
  • High cholesterol, especially elevated LDL and high triglycerides.
  • Smoking, even in amounts that are perceived as “few”.
  • Obesity and sedentary lifestyles.
  • Family history of early heart disease (mother, sisters, brothers).
  • Autoimmune diseases (lupus, rheumatoid arthritis, etc.).
  • Problems during pregnancy (preeclampsia, eclampsia, gestational diabetes) that increase future cardiovascular risk.
  • Transition to menopause with weight gain, high blood pressure and cholesterol changes.

If several of these factors accumulate, it makes sense to assess the heart proactively with a cardiological check-up.

When to ask for a cardiological evaluation

It is advisable to go beyond a “general check-up” if:

  • You have over 40-45 years old and several risk factors (hypertension, high cholesterol, diabetes, obesity), even if you feel “fine”.
  • Notes chest discomfort, shortness of breath or disproportionate tiredness to the effort, even if you think it may be “stress”.
  • You had preeclampsia, eclampsia or gestational diabetes and then your cardiovascular risk was not reassessed.
  • There is a history of heart attacks or other cardiovascular events at early ages in your family.

A targeted assessment includes a clinical history, physical examination, laboratory studies and tests such as electrocardiogram (ECG), stress test or echocardiogram, as appropriate.

Practical prevention for women's hearts

Prevention does not depend on a single action, but on several decisions sustained over time.

Blood pressure

  • Check it regularly, not just “when I feel bad”.
  • In many women with risk factors, the aim is to keep it below 130/80 mmHg, if medically reasonable.
  • If there are variable or discordant figures between home and office, it can be complemented with studies such as the MAP 24 h.

Cholesterol

Glucose and weight

  • Early detection and treatment of prediabetes or diabetes.
  • Avoid progressive weight gains; even losing 5-10 % of initial weight can make a difference.

Smoking

  • Smoking cessation significantly reduces the risk of heart attack, especially in women with other risk factors.
  • There is no “safe” number of cigarettes.

Physical activity

Stress and sleep

  • Prolonged periods of intense stress and poor quality sleep have been associated with increased cardiovascular risk.
  • This is a component that needs to be explicitly addressed, as detailed in Stress, sleep and heart health.

Warning signs: when to go to the emergency room

Go to the emergency room immediately (without driving yourself) if you present:

  • Pain, pressure or discomfort in the center of the chest lasting more than a few minutes or recurring, with or without irradiation to the arm, neck, jaw or back.
  • Recent onset severe shortness of breath, especially if accompanied by sweating, nausea or dizziness.
  • Upper abdominal or back pain with general malaise, nausea or cold sweat.
  • Fainting, feeling faint or marked weakness.

Even if you are not sure if “it's the heart”, in the context of risk factors, it is preferable to have a urgent assessment to stay at home waiting for it to go away.

What a comprehensive heart care strategy looks like for women

In practical terms, a good plan usually includes:

  • Know your key numbersblood pressure, cholesterol, glucose, weight.
  • Have a baseline cardiological assessment when there are risk factors or family history.
  • Maintain sustainable habits of nutrition, physical activity, sleep and stress management.
  • Be attentive to new symptoms and not normalize recurrent chest discomfort, shortness of breath or extreme tiredness.
  • If you have already had a cardiac event, completing a cardiac Cardiac rehabilitation and follow a plan of secondary prevention.

If you identify with several risk factors or have had compatible symptoms, you can use the form of contact to schedule an assessment and define a prevention plan tailored to you.

References

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