Ask The Doctor

Heart Attacks Affect Women Differently

Dear Dr. Garner,

I am 70 years old and last week, I got the shock of my life. While walking to the grocery store, I started getting pain in my left arm and I felt nauseous.

I assumed this was due to the spicy food I had earlier in the day until it got worse and I began to feel short of breath. Someone on the street saw me and called an ambulance. At the hospital, I was diagnosed with a heart attack.

I am really shocked as I have never had any problem before now. I always figured it would be my husband who would have a heart attack.

Heart Attack Surprise in South Ozone Park


Dear Heart Attack Surprise,

Not many women believe they will have a heart attack. The interesting fact is that more women than men die of heart attacks every year.

The symptoms in women are different from men. The most common heart-attack symptoms in women are shortness of breath, extreme fatigue, back and lower chest pressure. Chest pain is not always severe or even the most prominent symptom.

Sometimes women have a heart attack without chest pain. Women are more likely to have pain in their neck or jaw. They’re more likely to have pain the right arm, unusual fatigue, dizziness, sweating, nausea or vomiting. Women describe the chest pain as pressure or tightness. This may be due to the fact that women are more likely to have blockages in smaller blood vessels of the heart, causing a different type of pain than men. In women, the pain may occur at rest or during sleep.

Mental issues such as stress play a role. Depression may be an unrecognized warning sign as well. Because of a lack of understanding of heart attacks in women, a woman tends to show up in the emergency room after the damage has already occurred. They usually attribute the pain to indigestion or muscle pain.

There are certain risk factors for heart attack that can be controlled.

For example, diabetes increases the risk of heart disease significantly more in women than men. The metabolic syndrome which includes fat around the belly, high blood pressure, high blood sugar and high triglycerides has a greater impact on women than men. Stress and depression affect women’s hearts more than men. Lack of physical activity is also a major risk factor for heart disease as women tend to be less active than men.

Lifestyle changes should be instituted in women, such as quitting smoking, exercising 30 minutes a day, maintaining a healthy weight and eating a diet similar to the Mediterranean diet, which involves a lot of fruit, vegetables and whole grains (a glass of wine is a bonus). And if you can’t finish all of your exercising in one session, it is fine to break it up into 10- or 15-minute intervals. Exercise does not need to be in a gym, but may consist of housework or walking up a flight of stairs instead of taking the elevator.

It is important to know your BMI (body mass index). A score of 25 or higher can be associated with an increased risk of heart disease. The waist circumference is also a useful tool and women are considered overweight if their measurement is greater than 35 inches. Losing small amounts of weight can lower your blood pressure and reduce the risk of diabetes.

It is not necessary to have a drastic change. Women may not be candidates for angioplasty and stenting due to the fact their disease is in the smaller vessels of the heart. Some women may take a daily aspirin but you should speak with your doctor prior to starting this.

In summary, there are different symptoms and causes for heart attacks in women and men. Women often do not get “traditional” heart-attack pain, where they clutch their chest and pass out. They’re more likely to have different symptoms, which women typically ignore and then get to the hospital when it is too late to use many of the newer tools available. It is critical for women to get to the hospital as fast as possible.

I urge all women to become familiar with symptoms of heart attacks.

I hope this helps you and I look forward to hearing of your progress.

Dr. Garner is a Fidelis Care provider who is affiliated with New York Methodist Hospital, Park Slope. He also hosts “Ask the Doctor” on NET TV, Tuesdays at 8 p.m. on Time Warner Channel 97, Cablevision Channel 30 and Verizon FiOS on Demand.

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