Women’s heart

Why does the women’s heart deserve more attention?

Heart disease is common in women. Every year, more women die of cardiovascular disease than of breast cancer. Worldwide, cardiovascular disease is the number one cause of death in women.

The symptoms of heart disease in women are still too often missed, because they differ from those in men. As a result, the diagnosis is frequently made later. Symptoms are sometimes dismissed as hormonal, for example. In addition, women sometimes go to a doctor too late.

Women often explain their symptoms themselves

Women do not always quickly link their symptoms to their heart, especially when the symptoms are vague or atypical. I notice that when women come in with symptoms, they often already have an explanation ready. With increasing fatigue: "but it has also been a busy time". With palpitations: "it must be the menopause".

Because chest pain as a sign of vascular disease is often absent or only faintly present in women, they attribute their symptoms to being overtired or, for example, to getting older.

Symptoms can be atypical

While men go to the GP with a cramping or pressing pain in the chest, women come with symptoms such as fatigue, dizziness, nausea, shortness of breath and, for example, back pain. Heart symptoms in women can be atypical compared with most heart symptoms in men, yet for women these symptoms are in fact typical.

Heart symptoms in women often start with an erratic pattern of pain between the shoulder blades, a feeling "as if the bra is too tight". This does not resemble the classic pain, described as if an elephant is sitting on the chest and radiating to the jaw. As a result, women can have a heart attack without realising it, putting their health at serious risk.

Is the women’s heart different?

In broad terms, no. What does differ is that the coronary arteries in women are somewhat finer and smaller. The inner lining of these vessels is more sensitive to hormones and stress. Narrowings are less often found at isolated points, but are more diffuse and spread over longer sections. The coronary arteries are also more prone to spasms, sudden contractions of the vessel wall, which cause sudden symptoms of oxygen shortage in the heart muscle. An unpleasant, oppressive, tight feeling is usually the result. This can occur out of the blue; we call that an atypical symptom, but one that must be taken seriously.

Risk factors that play an extra role in women

In women, risk factors for cardiovascular disease such as high blood pressure are quite often wrongly attributed to stress or the menopause. If a woman has had high blood pressure during pregnancy, for instance, that can already be a forewarning of cardiovascular disease later in life: the risk is then 2 to 5 times higher.

Cardiovascular disease occurs in women on average 10 to 15 years later than in men. This is because, until the menopause, women are protected by female hormones (oestrogen). After the menopause, women produce less oestrogen and the risk increases. This also applies to women who reach the menopause early (younger than 35 to 40 years) or who have a naturally lower oestrogen level.

There are also women who develop heart disease at a much younger age, independent of oestrogen. In addition, women often have to do everything at once, and do it perfectly too. This causes increased stress, which leads to high blood pressure, and that is again a risk factor. Smoking, an unhealthy diet and lack of exercise also play a role.

Treatment differs as well

Vascular disease of the heart is not always treated with the same medication in women and men. Because vascular disease in women can be spread more diffusely across the coronary arteries, a different approach is needed. In that case you mainly use medication that widens the blood vessels. The choice of medication depends strongly on the severity of the symptoms and the risk factors present.

It is very important to take enough time for the consultation, to listen carefully and to map out all risk factors. So that every patient, including those with vague or atypical symptoms, receives the attention and treatment they need. Especially when coronary artery disease is suspected, the potentially important differences between the female and the male heart must be taken into account.

A special clinic for women

Heart Clinic has set up a special consultation for women who experience symptoms that may come from the heart, and for women with an increased risk of cardiovascular disease. You can be seen quickly, often within a few days.

In case of acute, severe or rapidly increasing symptoms, contact local emergency care immediately. Do not wait for a regular appointment.