The month of February is American Heart Month and this year, we want to highlight an often overlooked or misdiagnosed medical issue, women’s heart disease. Even though heart disease affects men and women equally, heart disease is the leading cause of death among women in the United States. But sadly, according to the American Heart Association, heart disease in women remains widely underdiagnosed and undertreated, resulting in worse health outcomes and an increased risk of death for women.
We encourage everyone, and especially women, to learn more about their own heart health, understand their risks, and know the symptoms of a potential heart attack.
What are the Symptoms of Heart Attacks in Women?
The stereotypical depiction of someone “clutching their heart and gasping for air” while experiencing a heart attack may make for a dramatic scene in a movie, but it rarely happens in real life, even in men. While chest pain or pressure remains the most common symptom of heart attacks for both men and women, it is more common for women to present without chest pain. Women often experience a combination of additional symptoms not usually associated with cardiac trouble, including:
- Nausea or vomiting
- Indigestion
- Stomach pain
- Upper back pressure
- Fainting or dizziness
- Shortness of breath
- Cold sweats
- Extreme fatigue
- Jaw pain
- Back pain
- Arm pain
- Pain between the shoulder blades.
A report by the American Heart Association found that heart attacks are deadlier in women who don’t experience any chest pain at all, in part because it means both patients and doctors take longer to identify the problem. The presence of additional symptoms should alert healthcare providers to the possibility of a heart attack, but all too often, it doesn’t.
Why is Heart Disease in Women Underdiagnosed?
Studies have shown that doctors often don’t understand the complexity and variety of heart attack symptoms and therefore downplay or dismiss what may seem like random symptoms, especially when there is no chest pain. Historically, a large majority of medical training and research centered on the male body, which all too often results in mis- or underdiagnosis for women. For many years, the same symptoms protocol was used for men and women for heart disease. As a result, women are less likely to be admitted to the hospital, receive less thorough evaluations, and are less likely to be administered tests to detect cardiac problems. Women are often told that their symptoms are related to “stress” or “anxiety” and research suggests that women are twice as likely as men to be diagnosed with a mental illness when, in fact, their symptoms are consistent with heart disease or heart attack.
In addition to the failure of healthcare providers to recognize and treat symptoms of heart attacks in women, women themselves often don’t know that certain symptoms are related to heart disease. Some women may be embarrassed to complain about seemingly small ailments, afraid of being seen as anxious or a hypochondriac. Other women may have multiple competing responsibilities at home or work that prevent them from taking the time to see a doctor for seemingly non-urgent matters. Others may live alone, or just don’t want to bother a medical professional with their problems so they wait and hope the symptoms subside.
Because of this, women wait almost twice as long to go to the hospital when experiencing a heart attack, attributing their symptoms to flu, indigestion, a stomachache, or stress. This delay in seeking treatment inevitably leads to poorer outcomes for women. Although providers are beginning to approach the evaluation of women differently than men, we encourage all women to advocate for themselves and their own health.
How to Advocate for Yourself
Being aware of the many subtle combinations of signs and symptoms of heart attacks in women is key to quicker diagnoses and treatment. Understand that although the average age for a heart attack for women is 69, deaths from heart attacks and heart disease in women between 35-54 is on the rise. Educate yourself on heart disease and your family’s medical history and speak with your doctor about your own risks.
If you experience any of the above unusual symptoms, see your doctor or visit the emergency room and insist that they screen for heart disease. If you know you have high blood pressure or other metabolic issues that make you more susceptible to a heart attack, tell the healthcare staff at the hospital your history and insist on the appropriate testing, such as an EKG, blood tests, or chest x-rays. Speaking up for yourself could save your life.
