Get the Facts: Heart Disease in Women

Cone Health cardiologist Katarina Nelson, MD, shares insights about the risk factors for and warning signs of heart disease in women, and provides tips on how women can protect their heart health.

Every other minute, heart disease kills a woman in the United States. In fact, heart disease is the number 1 killer of both sexes. Yet what many women don’t realize is that their risk factors for and warning signs of heart disease are different than those for men. Katarina Nelson, MD, a cardiologist at Cone Health Medical Group HeartCare, is committed to educating women about heart disease, and she sat down for a heart-to-heart talk about women’s cardiovascular health. Here’s what she thinks every woman needs to know about the risk factors for and warning signs of heart disease.

Do women downplay the risks and warning signs of heart disease?

Yes, frequently. Women tend to take care of their family members before they take care of themselves. They often don’t seek medical help until their symptoms are severe. By that point, their heart disease may already be at an advanced stage. Some women don’t see a cardiologist until they’re already having a heart attack. By that time, even if we place a stent or refer them for bypass surgery, they may have developed scars within the heart muscle. We want to prevent heart disease, or diagnose and treat it before it leads to these bad outcomes. To do that, we need to raise awareness about the problem.

Are the risk factors for heart disease the same for both sexes?

Men and women have a number of risk factors in common. They include:

• Older age.
• Physical inactivity.
• Unhealthy cholesterol levels.
• High blood pressure.
• Diabetes.
• A family history of early coronary artery disease (CAD), a condition that can lead to heart attacks.

Smoking is another shared risk factor. For men who smoke, the risk of developing CAD is three times higher than in nonsmokers. But for women who smoke, the risk is six times higher.

Some risk factors are female-specific. Women with a history of certain problems in pregnancy and childbirth—including pre-eclampsia, eclampsia, gestational diabetes, stillbirth and multiple miscarriages—have a higher lifetime risk of developing cardiovascular disease. Also, women with polycystic ovarian syndrome—a condition involving an imbalance in female sex hormones—have a greatly increased risk of developing CAD.

What warning signs of a heart attack should women watch for?

In the media, a heart attack is typically shown as crushing chest pain. But only about 60 percent of women experience chest pain or discomfort with a heart attack. Symptoms women are more likely to experience include:

• Shortness of breath.
• Sudden back, arm or jaw pain.
• Nausea.
• Vomiting.
• Weakness.
• Lightheadedness.
• Profuse sweating.
• Unusual tiredness.

If you think you might be having a heart attack, call 911. It’s always better to be safe than sorry.

How can women protect their heart health?

It’s never too early to begin protecting your heart. If you start now by exercising regularly, eating healthfully and not smoking, you’ll be doing yourself a favor for life. Get regular checkups, and work with your doctor to keep your cholesterol and blood pressure in the healthy range.

If something feels different, don’t ignore it. For example, maybe you could always walk up a flight of stairs or carry in a bag of groceries without a second thought, but it suddenly feels really difficult. Seek medical help to find out what’s behind this change. If the problem turns out to be heart disease, the earlier it’s diagnosed and treated, the better.

About the Author

Katarina Nelson, MD, is a cardiologist specializing in non-invasive cardiology and in wide range of cardiovascular imaging with Cone Health Medical Group HeartCare at Church Street.