How is women’s heart disease different than men’s heart disease?
Women and men have similar symptoms of heart disease, including the most common symptoms of chest pain or shortness of breath with physical activity. Throat tightness, left arm pain, sweatiness or feeling faint with activity are other symptoms seen.
Other less common symptoms include discomfort in the jaw area, neck or upper back. Some people present only with a noticeable increase in fatigue or inability to do activities they once could do. Women’s symptoms differ from men’s in that they have a tendency towards more of the less common symptoms.
Women’s outcomes after a heart attack appear to be worse than men’s. For example, more women die within the first year of a heart attack, women appear to develop heart failure more often than men and they are more likely to die after bypass surgery. Women have higher rates of depression and physical disability after a heart attack. Younger women also tend to have worse outcomes as compared to older women.
The reasons for this are varied but appear to be linked to non-recognition of the signs and symptoms of heart disease and subsequent delay in getting treatment. Women also have higher rates of additional medical problems, such as diabetes, which contribute to worse outcomes.
Women also have more microvascular disease. This is disease of the smaller vessels of the heart, which causes chest discomfort but not a significant blockage within the larger arteries. This frequently is quite distressful and affects quality of life for women but newer treatments are being developed to treat this condition.
Are there any female-specific disorders that increase a women’s risk of heart disease?
Yes, there are several. Polycystic ovarian syndrome (PCOS) is a condition that is often associated with obesity, hypertension and glucose intolerance, all traditional risk factors for heart disease. Some treatments for breast cancer may cause injury to the heart muscle. Turner Syndrome is a genetic condition that affects only females and they have a high incidence of hypertension and elevated cholesterol, as well as a greater likelihood of conditions that affect their aorta.
Pregnancy-related conditions such as premature birth, low-birth weight and pregnancy-induced hypertension often are risk factors for heart disease later on. Post-partum cardiomyopathy is a life-threatening condition that can occur after delivery.
Menopause often brings with it an increase in cholesterol levels, hypertension and weight gain, and researchers are investigating the connection of early menopause to earlier heart disease in women. We also commonly see women in the peri-menopausal period presenting with palpitations, which can be quite disruptive to their lives.
What should I do if I have symptoms suggestive of a heart condition?
If your symptoms are mild in nature, discuss them with your primary care physician to verify that it may be heart related. He/she may order testing to determine if your symptoms are related to your heart, or may refer you directly to the Women's Heart program.
If you develop more significant chest pain, shortness of breath or sudden rapid heart rate that does not resolve in 5-10 minutes, you should call 911 and be transported to the nearest emergency room. Do not drive yourself.
How does the Women’s Heart Program at the University of Michigan approach patient care for a woman presenting with symptoms of heart disease?
Women are individuals, and we focus our recommendations with her preferences in mind. Our initial visit typically includes a focus on physical symptoms, but we also assess emotional health, preferences for life-style changes and consider other medical conditions in our treatment plans. We offer a comprehensive program with cardiac rehabilitation, stress management, nutrition and exercise counseling as well as many testing modalities all in the same building. We recognize that women are very busy and being able to schedule specialized services on the same day is very convenient.
Our physicians provide the full range of cardiac care including prevention, diagnosis and treatment. We communicate and work with a woman’s primary care provider to ensure cost-effective care so services are not duplicated. We view ourselves as partners to helping women achieve optimal health.
How are researchers at the University of Michigan investigating women’s heart disease?
Our Women’s Heart Program faculty is currently, or has been, involved in several different studies that directly relate to women. Dr. Claire S. Duvernoy, the director of the program, has been involved in an international study of women and heart disease, as well as studies involving the effects of hormone therapy on cardiac blood flow and function, effects of obesity and weight loss on cardiac function and studies on the effects of cholesterol lowering medications on cardiac outcomes in women.
Cheryl L. Bord, a nurse practitioner with the team, has been involved in studies of women with heart disease as well as a large study on people with diabetes and depression. She has clinical experience in the areas of internal medicine and women’s health, and continues to practice in the gynecology service at UM in addition to the Women’s Heart program. She has a special interest in depression in women and post-menopausal health care.
Make an Appointment
Our Women’s Heart Program team has the clinical and research expertise to provide comprehensive care for women and their unique health conditions. A consultation can be arranged by contacting the Patient Care Center at 877-885-8444.