As a freelance writer, I researched and wrote patient-facing medical education content for niche publisher MD2P.net.
The company produced booklets and web content about various medical subjects and custom branded them for individual clinics to distribute to their patients.
My delivered manuscripts covered the following cardiology topics:
- Congestive heart failure
- Coronary artery disease
- Myocardial infarction
- Women and heart disease (text below)
- Bypass surgery
- Valvular disease
- Valve replacement/repair surgery
Heart disease is different for women
Women’s and Men’s hearts work the same way, but they seem to fail differently.
The silent majority
Coronary heart disease has often been perceived as a “man’s problem,” and that women are more likely to succumb to breast cancer. But in the U.S. alone, 42 million women live with cardiovascular disease (remember that strokes are part of this problem). In fact, cardiovascular disease kills almost twice as many women as all forms of cancer combined.
Less dramatic heart attacks
While chest pain (angina) is the most common symptom of heart attack (myocardial infarction) for both men and women, it is not a reliable indicator for women for two very different reasons:
- Women are not as likely to experience chest pain before or during a heart attack.
- Women who do experience chest pain may not be having a heart attack at all, even if they have already been diagnosed with heart disease. Women tend to describe their chest pain more as tightness, pressure or an ache.
Earlier warnings, often ignored
Women experience more pre-symptoms (prodromal) before an actual heart attack, granting precious extra time to seek medical attention. A clinical study by the National Institutes of Health observed this “early warning” trend in 95 percent of female heart-attack victims who were observed. Unfortunately, when a heart attack actually strikes, women are more likely to delay seeking emergency treatment—often resulting in permanent heart damage or death—because they think their symptoms are a false alarm.
Women develop coronary artery disease later in life
Men typically have a 10-year “head start” on developing heart disease. Women with active ovaries and normal estrogen production seem to be protected against hardening of the arteries (atherosclerosis), a primary cause of heart attacks, until after menopause. The percentages of men and women with heart disease equalizes by age 70, but women in that age range may have other medical conditions or complications that can limit more aggressive treatments.
Less medical knowledge about women with heart disease
Historically, only 27 percent of participants in all heart- and stroke-related research studies have been women. For decades, most research subjects were middle-aged, white men. As a result, symptoms of a heart attack are still divided into two lists: “typical” and “atypical.” A man who only has a couple of “atypical” symptoms is not in serious trouble. But the most common symptoms for women are often found down in that “atypical” list. To add to the difficulty in diagnosis, these “women’s symptoms” are easy to confuse with many other, non-coronary conditions.
The lack of understanding about this disease seems to go both ways
The American Heart Association reports that only 55 percent of women realize heart disease is their No. 1 killer and less than half know what are considered healthy levels for cardiovascular risk factors like blood pressure and cholesterol.
Heart disease risk factors that affect women more
- Cigarette smoking (stop!)
- Depression and/or mental stress.
- Reaching menopause (but estrogen replacement therapy may raise the risk further)
- Metabolic syndrome:
- High levels of LDL or “bad” cholesterol
- High blood pressure (hypertension)
- High blood sugar (hyperglycemia, usually via diabetes)
- Obesity (specifically around the waistline)
General risk factors
- High intake of fatty foods (eat less saturated fat, cholesterol and salt)
- Family history of heart disease
- Lack of physical exercise or labor
- Heavy alcohol consumption
- Age (65 for women, 60 for men)
Heart attack symptoms and pre-symptoms for women
Women seem to experience more early symptoms (prodromal) of a heart attack, often more than a month in advance, but the symptoms themselves can be hard to predict. Most of them commonly occur with people who have perfectly normal heart function, but if you carry several of the risk factors listed below, they may be real heart attack warning signs.
- Unusual fatigue that’s not caused by a lack of sleep, fighting off a virus, or prescription drug side-effects.
- Sleep disturbances: unusual or nightly difficulty staying asleep.
- Shortness of breath. This is a useful indicator for women who have not been diagnosed with heart problems before.
Symptoms during a heart attack
- When a man has a heart attack, he is more likely to grab his chest. When a woman has a heart attack, she is more likely to clutch her stomach or her head.
- Chest pain is still a key indicator of a heart attack for men and women, but many women have described other types of severe discomfort (pressure, tightness, aching, burning, sharpness, fullness and/or tingling) throughout the upper body (upper back, neck, arms, shoulders, and sometimes in the throat or jaw).
- Other symptoms
- Shortness of breath (dyspnea), which may or may not accompany upper body pain.
- Weakness or unusual fatigue
- Cold sweat