Gender Matters: Understanding the Differences in a Woman’s Heart

by Kristy Como Armand

When you ask women what their biggest health fear is, most will say breast cancer, even though heart disease is the leading cause of death for women in the United States, killing over 300,000 women each year. This makes heart disease responsible for about one in every five deaths in women. Breast cancer is responsible for an estimated one in 39 deaths in women, a much lower percentage. 

Many women might be surprised by a few other eye-opening statistics:

Heart disease kills more women than all other types of cancer combined.

Women have now surpassed men – more women than men die annually from heart disease than men do. 

A recent survey by the American Heart Association found that about half of the women interviewed knew that heart disease is the leading cause of death in women, but only 13% of those respondents said it was their greatest personal health risk. 

“While we’ve made some progress in helping women understand that heart disease is not just for men, we still have some work to do in getting women to understand and manage their own personal risk for cardiovascular problems,” says Dr. Prasanna Sugathan, board certified cardiologist with Imperial Health. Dr. Sugathan has a special interest in women and heart disease. “Death from this disease is preventable in most cases, but that opportunity is very often lost, particularly in women, who are not focused on their personal risk factors and symptoms. That’s where we need to increase awareness.” 

She explains the early, more treatable stages of cardiovascular disease are often invisible, as plaque deposits silently accumulate in the arteries. “All too often, a woman’s first clue to the obstruction may be a full-blown heart attack. Two-thirds of women who die of a heart attack have no prior symptoms in comparison to only half of men. This is why taking heart health action sooner, rather than later, is so important for women.”

Though women over 65 are most vulnerable to heart disease, middle-aged women are not invulnerable to risk. One in eight women between 45 and 64 show evidence of coronary artery disease. Most people would be shocked to realize that heart disease kills twice as many women in that age group as breast cancer – the disease women dread most. African American women are at an even higher risk. Heart disease is 69 percent more common among this group than in white women. 

So are women at a higher risk of heart disease than men, and if so, why? The answer, according to Dr. Sugathan, is yes and no. “Many of the risk factors for heart disease are basically the same for men and women, but the awareness of these risk factors, and how they are managed, can be different between the sexes.”

While traditional risk factors for coronary artery disease — such as high cholesterol, high blood pressure and obesity — affect both women and men, Dr. Sugathan says there are some other factors that may play a bigger role in the development of heart disease in women. These include: 

Diabetes

Depression and mental stress

Smoking

Inactivity

Menopause

Pregnancy complications

Family history of heart disease

Inflammatory diseases

Dr. Sugathan says another factor that impacts women’s survival rates from heart attacks is that the symptoms they experience may be different from the “classic” heart attack symptoms more common in men. 

The tightness in the chest and tingling of the left arm are often absent in women.  More common, subtle, symptoms of a heart attack in women include:

Discomfort in the neck, jaw, shoulder, upper abdomen or upper back

Shortness of breath

Pain in one or both arms

Unusual fatigue

Lightheadedness or dizziness

Nausea or vomiting 

Sweating

Palpitations

Unexplained anxiety

“Because women are not as aware and/or focused on their cardiovascular health, they may be more likely to ignore symptoms or attribute them to some other illness. This means they may wait too long to seek help,” says Dr. Sugathan. “And even when they do report their symptoms, if their doctor does not consider a cardiovascular cause, they could still be misdiagnosed, and the opportunity for timely cardiac intervention could still be missed. This is why we need women to be aware of their risk factors and warning signs and advocate for their cardiovascular health when they feel something is not right. Don’t be afraid or embarrassed to push for answers. It’s your heart – no one knows it like you do.” 

To schedule an appointment with Dr. Sugathan 

in Lake Charles, Sulphur or Jennings, call 

(337) 312-8281. 

With Heart Disease, 

Early Detection

Is Key

According to the U.S. Centers for Disease Control and Prevention, one in every four deaths in the United States is caused by heart disease. Most of those can be attributed to coronary heart disease. Also known as coronary artery disease, or CAD, it’s caused by a buildup of cholesterol and other substances in the arteries that can eventually block blood flow.

Unfortunately, many people don’t even know they have CAD until after they suffer a heart attack. But it is possible for CAD to be detected in an earlier stage. That’s crucial because early detection enables CAD patients to make lifestyle changes and start treatments that can control the disease and reduce their risk for complications.

The key for early detection is to undergo regular screening tests — usually at your primary care doctor’s office — that detect CAD risk factors. There are multiple risk factors for CAD. That’s why it is important to have annual wellness exams even if you are not having any problems.

The American Heart Association (AHA) recommends these heart-health screenings:

Blood pressure. Your doctor should check your blood pressure at every regular visit or at least once every other year if your blood pressure is below 120/80.

Cholesterol. It’s reasonable to have your cholesterol checked once a year, though the AHA says every four to six years is okay if you aren’t at high risk for heart disease and stroke.

Weight/body mass index. This should be checked at your regular health care visits.

Waist circumference. Your waist circumference should be checked as needed (your doctor can make the call) if your BMI is at least 25.

Blood glucose test. At least once every three years.

People who are at increased risk of developing CAD may be monitored more closely by their doctors. Those at higher risk include smokers and anyone with family members who’ve had the disease. Having high blood pressure, diabetes, or high cholesterol can also increase your risk.

Many of those factors are controllable, however. The most important thing to do is minimize those risk factors. No smoking, get regular exercise, adhere to a healthy diet, and maintain a healthy weight. If you have diabetes, you should aggressively control it as well as high blood pressure and cholesterol.

But if screening tests indicate a problem and your doctor does suspect CAD, he or she may recommend any of several tests to confirm the diagnosis. These include:

An electrocardiogram, or EKG. This is a simple, painless test that records the heart’s electrical activity and can show signs of heart damage.

Stress testing.  During a stress test, you exercise to increase your heart rate. The test can detect abnormal changes in your heart rate, heart rhythm, or blood pressure.

Echocardiography. Sometimes simply called echo, this test uses sound waves to create a moving picture of your heart that can reveal poor blood flow and areas of the heart that aren’t working correctly.

Chest X-ray. X-rays also provide pictures of your heart.

Blood tests. These will detect abnormal levels of fats, cholesterol, and other substances in your blood.

Coronary angiography and cardiac catheterization. During this test, a doctor will insert a thin tube into a blood vessel and thread it up to your coronary arteries. A dye is sent through the tube, and X-rays are taken while the dye is flowing through your arteries. This lets the doctor study the flow of blood in your heart and blood vessels.

Just remember that although early detection of heart disease can protect your future health and maybe even save your life, preventing it in the first place should be the ultimate goal.