Different Symptoms for Men and Women with Heart Disease

Women's hearts are different from men's

Women's hearts are different from men's. This area of study is fairly new, and research is underway to further examine differences in the physiology and pathophysiology of women's hearts. We do know that women have smaller hearts and smaller arteries than men. Researchers from Columbia University and New York Presbyterian Hospital believe that women also have a different intrinsic rhythmicity to the pacemaker of their hearts, which causes them to beat faster. These same researchers believe that it may take a woman's heart longer to relax after each beat. Some surgeons also hypothesize that the fact that women have a 50 % greater chance of dying during heart surgery than men could be related to some fundamental difference in women's the way women's hearts work. These differences may also account for the fact that women are more likely to die after their first heart attack.

Heart attack symptoms different in women

Women are about as likely to have a heart attack as men, but the fact that they are more likely to die after their first heart attack may be because the symptoms of heart attack are different in women. Doctors and patients often attribute chest pains in women to noncardiac causes, leading to misinterpretation of their condition. Men usually experience crushing chest pain during a heart attack. Women may have a greater tendency to have pain just under the breastbone, or complain of abdominal pain, indigestion, difficulty breathing, nausea and unexplained fatigue. Women are therefore easily misdiagnosed of indigestion, gall bladder disease, or an anxiety attack. The likelihood of misdiagnosing a heart attack in women is also increased by the fact that women tend to have heart attacks later in life, when they often have other diseases (such as arthritis or diabetes) that can mask heart attack symptoms.

Significant differences exist between men and women in the clinical presentation of heart attack and in the response to treatment. Women having a heart attack are likely to be older and have a higher incidence of high blood pressure, diabetes, high cholesterol, and congestive heart failure than do men. They are less likely to be smokers. The symptoms of acute heart attack are slightly different in women. Women are more likely to have neck and shoulder pain, abdominal pain, nausea, vomiting, fatigue, and shortness of breath in addition to chest pain. Silent heart attacks are more common in women. Often, because of these atypical symptoms, women seek medical care later than do men.

Even after arrival at the hospital, women may encounter delay in establishing the diagnosis of heart attack. Women are somewhat less likely than men to have the typical EKG findings to diagnose acute heart attack. Women with heart attack are generally more ill than are men. Despite this, women are paradoxically less likely to receive aggressive clot-busting treatments and are more likely to receive it later than do men. Women are also less likely to be admitted to a coronary care unit.