How Heart Disease Affects Women

by Cindy Gray

In the United States one in four women will die from complications due to heart disease. The most common type of heart disease is called coronary heart disease or CHD and is the number one killer of men and women in this country.  However, there are heart problems in women that are more common than in men.

There are certain heart problems that are more common in women than in men.  Let’s take a look.

Coronary Microvascular Disease

Women admitted to the hospital with chest pains but may have a clear angiogram, meaning no arterial blockages. A stress test usually reveals that not all areas of the heart are getting enough oxygen rich blood which is causing the pain, but often a physician cannot immediately determine the source of the problem, which can delay treatment and can cause further heart damage.  It’s most likely coronary microvascular disease (MVD) and it is much more common in women than in men.

Coronary heart disease is usually detected because major arteries that supply blood to the heart become blocked with the build up of a substance called plaque.  The artery may rupture or cause a blood clot that leads to a heart attack.

Coronary Microvascular Disease (MVD), however, is a problem in the human-hair sized arteries that also supply much needed oxygenated blood to the heart. When they become restricted, the heart muscle becomes deprived of oxygen, which can lead to a heart attack that can lead to permanent damage.  Coronary Microvascular Disease rarely shows up in traditional angiograms, making it extremely difficult to diagnose; and the medical community has only recently learned more about this confounding heart condition.

One theory currently being researched is that it may be more prevalent in women than men because of the drop in estrogen as women enter menopause. Unfortunately much more research needs to be done to understand and diagnose this female-centric heart disorder.

Broken Heart Syndrome

Yes, you can literally die of a broken heart. It’s a scientific fact and women are much more likely to be afflicted by this heart problem than men. 

Broken heart disease also goes by the name of stress-induced cardiomyopathy.  Regardless of the name, this heart problem can lead to severe short-term muscle failure. While it is not an actual heart attack per se, it is painful and often more misdiagnosed in women than in men.

Broken heart syndrome is a sudden intense reaction to stress hormones than can be brought on by severe emotional distress, romantic betrayal, break-ups and/or divorce. The sudden excruciating chest pain is often first diagnosed as a heart attack, but tests will show the major arteries are not blocked. The problem is part of the heart temporarily becomes enlarged and can’t pump normally like the rest of it, again making it difficult to diagnose.

The good news is that broken heart syndrome does not permanently damage the heart and it is possible to make a full recovery in a few weeks. Those who have had it once can be more likely to suffer from it again.

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Symptoms of broken heart syndrome include sudden intense chest pain (aka angina), an irregular heartbeat (aka arrhythmia), and shortness of breath. If you have no history of heart disease, are at a low risk for heart attacks and have experienced an emotionally painful event recently, chances are you have stress-induced cardiomyopathy, or a broken heart.

Why it affects women more often than men is not clearly known. Depression, anxiety and other mental health issues more common in women may be what links this kind of heart disease to the fairer sex, but more research is necessary to establish that for sure.

Heart problems in women definitely need to be studied more because of the stark differences in symptoms in men and women; and the difficulty of diagnosing microvascular heart disease or broken heart syndrome. 

Regarding symptoms, women tend to experience more severe shortness of breath, nausea or vomiting, and back and jaw pain; in addition to pain in the chest, breaking out in a cold sweat, and pain radiating down one or both arms (which is more common for men.)  Because the symptoms can appear to be less severe in women, they are diagnosed more slowly, leading to more heart damage because of a delay in treatment.

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