How To Observe Women's Heart Week

Considering heart disease is the leading cause of death in men, it is often viewed as a gender-specific condition. The reality is it affects women just as much – heart disease is also the leading cause of death among women. Despite these figures, only half of women realize that heart disease is responsible for 20 percent of female deaths yearly. Further, many women are unaware heart disease is seven times deadlier than breast cancer

In conjunction with Women’s Heart Week, we will highlight why heart screenings are so important, how women can have unique risk factors and symptoms compared to men and how lifestyle changes can improve your cardiovascular health outlook.

Common heart conditions

When someone refers to heart disease (also called cardiovascular disease), they are using an umbrella term to describe any type of condition that affects the heart and blood vessels.

Here are the most common types women deal with:

Coronary artery disease: Coronary artery disease is the most common type of heart disease. It occurs when plaque builds up and causes blockages in the arteries that supply blood to the heart. Chest pain is the most common symptom due to the narrowing of arteries that impact blood flow.

Arrhythmia: This group of conditions include any type of electrical disruption that causes an irregular heartbeat, either too fast (tachycardia) or too slow (bradycardia). Atrial fibrillation and atrial flutter system are two common types of arrhythmia. 

Heart valve diseases: The heart has four valves – mitral, tricuspid, pulmonary and aortic – that keep blood flowing. Heart valve diseases occur when these valves don’t work properly (too tight or too loose). Examples include mitral valve prolapse, mitral regurgitation and aortic stenosis.

Microvascular disease: Also called small vessel disease, this type of heart disease is categorized by damage to the small vessels that help blood flow to the heart.

Heart failure: Your heart can ultimately fail when it doesn’t pump blood as well as it should. When the heart doesn’t work as well, fluid backs up into the lungs and can cause shortness of breath. Common conditions that lead to heart failure include high blood pressure or coronary artery disease. 

Congenital heart disease: This category of heart disease includes heart conditions you’re born with. They can impact various areas of the heart. Ventricular septal defect is the most common type. Many babies are also born with atrial septal defect, single ventricle defects or pulmonary valve stenosis

Cardiomyopathy: This condition occurs when the heart can’t pump blood properly. Left untreated, it can lead to heart failure. Dilated cardiomyopathy is a type of cardiomyopathy in which the left ventricle becomes too enlarged to allow blood to flow efficiently. Cardiomyopathy is often inherited but it can be caused by high blood pressure, diabetes or obesity.

Peripheral artery disease: Like coronary artery disease, peripheral artery disease occurs when a buildup of plaque doesn’t allow blood to flow properly through your arteries. The difference with peripheral artery disease is these blockages occur away from the body in your arms, legs or other organs.

Broken heart syndrome: This condition is a type of stress cardiomyopathy that occurs when sudden stressful or emotional events rapidly weaken heart muscles. As the name suggests, it can be triggered by the death of a spouse that emotionally leads to a broken heart. Symptoms typically resolve quickly and aren’t chronic.

Do heart conditions affect women differently than men?

The way in which heart conditions can affect people varies greatly based on gender. While many men experience classic chest pain with their heart issues, women tend to present atypical symptoms that are harder to differentiate. 

Symptoms in women can be confused for anxiety or even gastrointestinal problems such as acid reflux. This gap often leads to heart disease being underdiagnosed in women. 

But why does this happen? Researchers have found it's a combination of anatomy and hormones. For example, the physical construction of a woman’s heart differs from a man in that it has smaller blood vessels, thinner ventricles and smaller heart chambers. These three physical features make it more likely to have issues with blood flowing to and away from the heart. Women also have fewer red blood cells, so their blood doesn’t contain as much oxygen as men.

As for hormones, women have estrogen and progesterone to assist with sexual and reproductive development. Both play an important role in heart health. Progesterone helps regulate blood pressure, so lower levels of this hormone can lead to high blood pressure. Additionally, estrogen can regulate cholesterol levels by increasing HDL cholesterol and decreasing LDL cholesterol, while helping to relax and dilate blood vessels to improve blood flow.

During menopause, women produce less estrogen and progesterone, which increases the risk of heart complications later in life.

Women are also more prone to developed health conditions that increase the risk of cardiovascular disease, such as rheumatoid arthritis, stress and depression.

Heart attack symptoms in women

Men who have heart attacks typically have chest pain, which is often depicted in pop culture or advertising – you’ve likely seen a commercial for heart medicine where a man clutches at his chest.

However, women may suffer from silent heart attacks and can experience anything from nausea and indigestion to dizziness. Women are more likely than men to experience pain in the neck, jaw, throat, stomach, or back. These uncommon symptoms can be confusing -- some symptoms may even be present for weeks or months before a heart attack.

Here is a list of atypical symptoms a woman may experience before a heart attack:

• Difficulty breathing
• Excessive sweating (feeling clammy)
• Heartburn
• Insomnia
• Lightheadedness or dizziness
• Nausea
• Numbness in lips, hands or feet
• Pain in the neck, jaw, shoulder, arms, upper back, or abdomen
• Persistent dry cough
• Restlessness
• Vomiting
• Weakness or excessive fatigue

The difficult nature in detecting these atypical signs is that these symptoms are also common in many other health conditions. Certain symptoms may stand out, though. Excessive fatigue is one example. Many women experience low energy for various reasons, but dramatic fatigue associated with an impending heart attack can cause you to become overly tired when making the bed or cooking dinner. Likewise, you should be alarmed if you suddenly become short winded and have difficulty breathing when walking to the bathroom.

Heart disease screenings and when to see a doctor

Being cautious is always the better approach when it comes to your heart. If you feel something is off, contact your doctor or visit your local emergency room or urgent care. A healthcare professional can perform various tests to check your heart. As important as it is to react to potential symptoms, you should also talk to your doctor about heart screenings to prevent or manage any health issues.

Here are some common screenings or diagnostic scans your doctor may perform:

Blood pressure reading: Blood pressure consists of two factors: systolic blood pressure and diastolic blood pressure. Systolic blood pressure measures the force or pressure on your arteries during each beat, while diastolic blood pressure measures the force or pressure on your arteries between heart beats. High blood pressure (defined as systolic above 130 mm Hg and diastolic above 80) increases your risk of heart disease.

Blood work: A simple blood draw can check your blood cholesterol levels. High cholesterol is linked to heart disease. A total cholesterol level under 200 is considered healthy, 200 to 239 is defined as at-risk and anything above 240 is deemed high cholesterol.

EKG: Also known as an electrocardiogram, this test measures the electrical signal of your heart and can detect abnormalities of the rate and regularity of your heart beat.

Echo: Also known as an echocardiogram, this test uses an ultrasound to take pictures of your heart.

Stress test: This test uses physical activity or medications to increase your heart rate to measure how well the heart functions and handles blood flow.

X-ray: An x-ray takes a picture of your chest and surrounding organs that can help outline blood vessels and detect abnormalities in shape or structure, such as calcium deposits.

Cardiac catheterization: This procedure is performed by a cardiologist and involves the insertion of a thin tube called a catheter (either through the arm, leg or neck) that can diagnose how well your heart performs. Your doctor can also collect blood samples and inject a special die to check for coronary artery disease.

Coronary angiogram: This type of scan measures how blood flows through arteries or veins to check for blockages. An angiogram uses dye that lights up wherever it flows through the heart. The scan can use X-ray, MRI or CT (computed tomography) to record the pictures. Women are more likely to have smooth layers of plaque that are harder to detect on an angiogram.

Coronary artery calcium scan: This scan uses computed tomography to check coronary arteries for calcium deposits called calcifications. A calcium scan can help detect early signs of coronary artery disease.

Ankle brachial index: This screening uses blood pressure readings in your feet and arms to measure how well blood flows to your lower extremities. An ankle brachial index screening can help diagnose peripheral artery disease. 

What can women do?

While some risk factors for heart disease are out of a woman's control (age or family history), there are lifestyle changes that exist to lower your risk. High blood pressure, high cholesterol and smoking are all risk factors of heart disease, and nearly half of Americans fall under at least one of these categories.

High blood pressure has no symptoms, so it’s important to have your blood pressure checked if you’re at risk of heart disease. In the past, this would occur whenever you visited a primary care physician. Nowadays, many people keep tabs on their blood pressure using an at-home monitor.

People with high cholesterol usually don’t have symptoms, either. Keep tabs on your cholesterol by scheduling annual blood works with your primary care physician. Using a blood draw, your blood will be tested for total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides.

Talk to your doctor about how you can lower your blood pressure, either with lifestyle changes or medications. Examples include diet modifications and physical activity. 

As for smoking, smoking impacts your heart in several ways. First, it can increase plaque formations in blood vessels. Nicotine found in cigarettes also raises your blood pressure. Finally, carbon monoxide found in smoke decreases the oxygen in your blood, forcing your heart to work harder.

The warning signs of heart conditions in women can be either silent or difficult to tell apart, which heightens the importance of staying on top of your health.

At INTEGRIS Health, we offer a $50 heart scan as part of our INTEGRIS Health Advanced Cardiac Care program. We also have an extensive team of heart doctors and medical professionals at the INTEGRIS Health Heart Hospital to perform heart scans, cardiac catheterization, open heart surgery and heart transplantation.