Understanding Heart Disease in Women

Heart Disease in Women Is Misunderstood and Poorly Treated

Female doctor discussing with a patient
Eric Audras/ONOKY/Getty Images

Many many women, and many doctors, don't know that heart disease is the number one killer of women, and the most common cause of disability. Furthermore, the heart disease that is seen in women is often not quite the same as heart disease in men. It may be more difficult to diagnose, and more difficult to treat.

These facts lead to two common (and sometimes tragic) mistaken beliefs held by many women and their doctors: That women don't really get much heart disease, and when they do, it behaves pretty much like the heart disease that men get.

The truth is that not only is heart disease very common in women, but also, when women get heart disease it often acts quite differently than it does in men. Failing to understand these two fundamental truths leads to a lot of preventable deaths and disability in women with heart disease.

A Top Killer of Women

In a survey conducted by the American Heart Association, 6 in 10 women said that the major threat to their health was breast cancer; only 1 in 10 said it was heart disease.

But in 1999, while cancer was killing 264,000 American women (41,000 of whom died of breast cancer,) cardiovascular disease killed almost twice as many (513,000) -- and it's the same story every year. In fact, each year since 1984, more women than men have died of heart disease.

Many doctors don't get it either. Less than half the doctors in one survey considered heart disease to be a major threat to their female patients.

Worse, less than half of all women receiving regular medical care say that their doctors have ever talked to them about reducing their risk of heart disease.

Symptoms Are Profoundly Different in Women

Perhaps most disturbing of all, the symptoms of heart disease -- and even the heart disease itself -- can be quite different in women than in men.

Since most medical textbooks describe "typical" heart disease (that is, the kind men get), doctors often fail to recognize heart disease when they see it in their female patients. The fact that heart disease is so common in women, and at the same time is underestimated and misunderstood by both women and their doctors, contributes in a big way to the high death rate.

If you are a woman, you need to know the basics about heart disease - especially heart disease as it behaves in women. The articles listed here emphasize the special characteristics of heart disease in women, that every woman should know about.

1. Protect Yourself: Cardiac Risk Factors in Women

The "classic" risk factors for heart disease generally pertain to both men and women. But if you are a woman, there are several additional things you need to consider in order to prevent heart disease.

2. Heart Disease Symptoms in Women

Women who have heart disease often experience symptoms differently than men - and their doctors might be misled by these differences.

As a woman, you need to be aware of the ways in which the symptoms heart disease you can be different from the symptoms described in your doctor's textbook.

3. Coronary Artery Disease in Women

Coronary artery disease (CAD) is the most common variety of heart disease in both men and women. But CAD can behave in some surprising ways in women, which can lead doctors down the wrong path.

4. Heart Failure in Women

Heart failure is ​a common cardiac condition that also has some unique features in women. If you are a woman who has heart failure, here is what you need to know.

5. Other Cardiac Conditions Especially Affecting Women

In addition to CAD and heart failure, there are several other cardiovascular conditions seen in women that can be puzzling or misleading to doctors. These include dysautonomias, palpitations, inappropriate sinus tachycardia, postural orthostatic tachycardia syndrome (POTS), and mitral valve prolapse.

Sources

Mosca, L, Manson, JE, Sutherland, SE, et al. Cardiovascular disease in women: a statement for healthcare professionals from the American Heart Association. Writing Group. Circulation 1997; 96:2468.

Stangl V, Witzel V, Baumann G, Stangl K. Current diagnostic concepts to detect coronary artery disease in women. Eur Heart J 2008; 29:707.

Mieres JH, Gulati M, Bairey Merz N, et al. Role of noninvasive testing in the clinical evaluation of women with suspected ischemic heart disease: a consensus statement from the American Heart Association. Circulation 2014; 130:350.

Continue Reading