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Mercy Women's Care at St. Anne
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Toledo, OH 43623

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Heart Attacks often Different for Women

separator Jaw pain. Cold sweats. Nausea. Indigestion. Trouble breathing. Are these the symptoms you think of when you hear the words "heart attack?" Maybe not, but maybe you should, especially if you're a woman.

Women and men often have heart attacks differently. Men are more likely to experience chest pain and pressure. Women may experience chest pain too, but they're more likely to have the less well known symptoms, like the cold sweats, nausea and jaw pain mentioned above.

Our culture often thinks of a heart attack as something that happens to men. A woman can be having a heart attack and think she's having flu or menopause symptoms instead. It's important to raise awareness about this issue, because heart disease is the number one killer of women. And when you're having a heart attack, every minute matters. The sooner you begin receiving emergency treatment, the higher your chances of survival, and the less damage your heart will incur. In many cases, people having a heart attack can get clot-dissolving drugs in the ambulance on the way to the hospital. This early step can keep heart muscle from dying.

Some women's heart statistics:
  • Heart disease kills 9,000 U.S. women under age 45 each year
  • Each year, 74,000 women under 65 die of heart disease
  • The younger a woman is when she has a heart attack, the more likely she is to die from it
  • African-American women are 69 percent more likely to die of a heart attack than Caucasian women
Risk Factors for Women
The risk factors for women are about the same as they are for men:
  • Family history of the disease
  • Smoking
  • Cholesterol higher than 240; blood pressure higher than 140/90
  • Sedentary lifestyle
  • Being 55 and past menopause (this risk factor is unique to women, of course)
  • Diabetes
  • Being African-American
What's Menopause Have to do with It?
The hormone estrogen tends to protect women from developing heart disease. It affects the levels of HDL (good) and LDL (bad) cholesterol in the blood. Estrogen seems to increase HDL and decrease LDL. As women approach menopause, their estrogen level drops. This is why it's more common for women to have their first heart attack at an older age than men usually do.

Researchers have been investigating whether hormone replacement therapy, which women take to relieve the symptoms of menopause, can offer protection against heart disease as well. It's a complex issue, one that women need to discuss carefully with their doctors. Some research has indicated that women who already have heart disease should not initiate HRT, while other study results are not conclusive.

If you are in menopause or getting close, be sure to talk with your doctor about your risk for heart disease. Understand that the decision to begin HRT is based on many factors-your risk for certain cancers and osteoporosis, the severity of your menopausal symptoms and your health status in general.

The Goal: A Heart Disease Diagnosis before the Heart Attack
Even women who know that heart disease is common for their gender may not be aware that they can develop the condition well before menopause. Women in their 40s are not immune to heart attacks.

Having a healthy lifestyle is one of the best ways to lower your risk of having a heart attack, but getting the right medical checkups is important too. Many women report that they go to their doctor with heart attack symptoms, but are told that nothing is seriously wrong with them. If you find yourself in a similar situation, don't be shy about pressing the issue. If you are convinced that there's a chance that something is seriously wrong, ask for an EKG and a stress test. Insist on it, in fact. These will reveal whether you're having a heart attack or not.

Remember, even young, active women with a healthy lifestyle can have heart disease.

M. Oz. Healing from the Heart, Plume, New York, 1999; F. Pashkow, C. Libov. The Women's Heart Book. Hyperion, New York, 2001; J. Reichman. Relax, This Won't Hurt. Quill, New York, 2000; The National Heart, Lung, and Blood Institute
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