Every year, more women die from heart disease than from all cancers combined. So why aren't we talking about it? Many of us falsely presume this deadly condition mostly affects men – but this isn't quite the case, and rates are only growing on both fronts. Let's dive into how heart attacks may present differently in women and what to look out for. 

Cardiovascular disease, including heart attacks, is the leading cause of death in women globally, accounting for about 1 in 3 female deaths – but women are more likely to be underdiagnosed and undertreated for heart disease compared to men, and studies have shown they’re also less likely to survive due to a delayed recognition of symptoms. So, what is the difference? It turns out, the symptoms are pretty easy to recognise, it’s just a matter of getting the word out and updating decades of misinformation and ill-informed doctors. Should be a breeze, right? 

Understanding the Gender Divide in Heart Health

While heart disease has long been considered a "man's problem," the truth is that it poses an equally grave threat to women. Yet, the underestimation of gender-specific heart risks, coupled with the lack of awareness, has led to dire consequences for women. Cardiovascular disease encompasses a spectrum of heart issues including heart attacks, strokes, and heart failure, has often been associated with men – and while the rates of this disease is certainly high among men, women aren’t left unscathed. Quite the opposite, actually. The reason? A differing presentation of symptoms. These differences can lead to misdiagnosis or delayed treatment in women, with doctors often brushing off the symptoms women report.

While men typically experience the classic symptoms of crushing chest pain or discomfort that send alarm bells ringing for any doctor or emergency responder, women might manifest subtler signs:

• Shortness of Breath: Women might experience breathlessness even before chest pain.
• Fatigue: Unusual fatigue that can last for days, not necessarily related to physical exertion.
• Nausea and Vomiting: Women might feel nauseous or vomit during a heart attack.
• Back, Neck or Jaw Pain: Discomfort might be felt in the upper body rather than the chest.

Certain risk factors have a stronger impact on women, including hormonal changes during menopause which can lead to decreased levels of estrogen, which has a protective effect on blood vessels. Women with diabetes are also at a higher risk of heart disease compared to men with diabetes. Even conditions like depression and chronic stress can influence heart health more significantly in women.

The Peril of Underdiagnosis

The failure to recognise these gender-specific symptoms and risk factors has led to underdiagnosis and undertreatment of heart disease in women. Women are more likely to be misdiagnosed, with serious consequences for their health. A delayed diagnosis means a delayed response, potentially impacting the effectiveness of life-saving interventions.

• Education and Empowerment: When women are aware of the unique signs and symptoms of heart disease, they’re better able to advocate for their health to doctors and medical professionals. (Of course, during a heart attack where time is of the essence, dismissive doctors can be an insurmountable obstacle in the way of treatment! That’s why education and changing protocol is vital across the board.
• Medical Training: Healthcare professionals need better training to recognise gender-specific heart symptoms.
• Research Inclusivity: Clinical research must include diverse populations to understand the intricacies of heart disease in both men and women. Researchers excluding women from studies is an issue that affects women’s health in everything from mental health and heart health to brain, gut and bone health.

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