Heart attack in women
Unlike men, a heart attack in women can often be less pronounced and pronounced, and usually at a more mature age. But help is also needed quickly to minimize complications and consequences.

Heart disease is the leading cause of death in our country, especially in the elderly. They account for five times more deaths in women over a lifetime than breast cancer. Moreover, in women, 20% of acute heart attacks are asymptomatic. Patients with diabetes are at particular risk – they are more likely to have atypical symptoms, similar to problems with the lungs or stomach.

When the first signs of a heart attack appear, immediate medical attention is important. Ideally, at the first sign of a heart attack. But about a third of women do not experience chest pain, 71% of women report flu-like symptoms that can last from 2 weeks to 1 month before the woman feels more discomfort or severe shortness of breath.

Patients’ lack of awareness may contribute to the milder symptoms of a heart attack experienced by some women not being reported to emergency room staff.

What is a heart attack?

Acute myocardial infarction is an occlusion of a coronary artery, leading to necrosis (death) of the myocardial muscle, followed by scarring.

Like every other part of our body, the heart needs a good supply of oxygen to function properly. The coronary arteries fulfill this need. But due to unhealthy diet and lifestyle, fatty deposits or plaques form on the walls of the coronary arteries, which over time can turn into a blockage. Any blockage in an artery prevents blood from reaching part of the heart muscle. This causes ischemia of the heart, a condition in which part of the heart is deprived of oxygen. When ischemia is not noticed or treated for too long, heart tissue begins to die and leads to a myocardial infarction (also called a heart attack).

Men and women have differences in the mechanisms of heart attack. There is a significant number of women with normal arteries on an angiogram (image of blood vessels after they have been injected with a contrast agent) who show biochemical or visual signs of a heart attack. More than one third of women with a heart attack, despite the absence of overt coronary artery disease, have plaque rupture and ulceration when examined by intravascular ultrasound.

Studies have shown that female patients with myocardial infarction are on average older than male patients and have more comorbidities (eg, obesity, hypertension, diabetes, mental health problems). There are some differences in the symptoms of a heart attack.

Fact! The female heart is usually smaller compared to the male due to the thinner walls of the heart chambers. It contracts faster than the male, but pumps 10% less blood.

Signs of a heart attack in women

Symptoms of myocardial infarction in women can vary from woman to woman, but the most common signs of a heart attack are:

  • chest pain or discomfort that comes on suddenly and doesn’t go away, pressure, tightness, or squeezing may be felt;
  • the pain may radiate to the left or right arm, or radiate to the neck, jaw, back, or abdomen;
  • the woman may feel nauseous, sweaty, dizzy, or short of breath.

Other less common symptoms include:

  • a sudden feeling of anxiety, similar to a panic attack;
  • persistent cough or wheezing.

Causes of a heart attack in women

A heart attack occurs due to damage to the coronary arteries in the heart. The coronary arteries are blocked for various reasons, and this leads to a lack of oxygen in the heart. This condition is known as coronary artery disease, which is the main cause of most heart attacks.

In other cases, a heart attack occurs when the plaque that forms in the heart ruptures, allowing cholesterol and other substances to enter the bloodstream. During rupture, the blood clot blocks the oxygen supply to the heart.

In rare cases, a heart attack is caused by spasm of blood vessels.

In general, there are several risk factors associated with a heart attack that cannot be controlled or changed, such as:

  • gender – men are more prone to heart disease and heart attacks than women;
  • family history – a genetic heart disease transmitted from ancestors that cannot be controlled or changed can cause a heart attack;
  • age – people over 65 are at greater risk of having a heart attack.

But there are other factors that can be reduced:

  • smoking – prolonged exposure to tobacco smoke can cause heart disease;
  • Obesity – Being overweight can cause serious health risks due to high cholesterol, high triglycerides, high blood pressure and diabetes, but regular weight loss exercise can reduce the risk of heart attack.
  • stress – it causes an undesirable effect on the heart, which increases the likelihood of it stopping;
  • high blood pressure – if a woman suffers from high blood pressure, it is important to monitor it and keep it under control with appropriate medication;
  • Diabetes – high blood sugar levels and insufficient insulin supply can damage various organs of the body, including the heart.
  • malnutrition – it is important to follow a balanced diet every day, which should include fresh fruits and vegetables, and fatty foods should be reduced – they lead to heart disease;
  • Alcoholism – Excessive alcohol consumption is a risk factor for heart attack.

Women also have additional risk factors for a heart attack:

  • pregnancy;
  • decreased production of estrogen hormones after menopause.

Treatment of a heart attack in women

If there is a suspicion of myocardial infarction, you should immediately call an ambulance. Women, unlike men, even in the presence of warning signs, rarely immediately go to the ambulance. Meanwhile, this can dramatically reduce the chances of survival and full recovery. Rapid treatment is very important, the goal of which is to restore blood flow to the affected part of the heart muscle as soon as possible. This helps limit the amount of damage to the heart.

Diagnostics

To confirm the diagnosis of a heart attack, doctors use the following tests:

  • Electrocardiogram (ECG) – The electrical picture of the heartbeat is recorded through electrodes attached to the skin. An injured heart sends out irregular impulses that can be seen on film, and this indicates signs of a heart attack.
  • Echocardiogram Sound waves travel through the heart from a device called a transducer that is pressed against the chest. This procedure produces video images of the heart. Echocardiogram images help pinpoint the exact location of the injury.
  • Coronary catheterization (angiogram) – the catheter is inserted through an artery from the leg or groin to the heart. A colored dye is then passed through the catheter to show the arteries in the heart. An x-ray is taken to see the blockage in an artery in the heart.
  • Blood test – damage to the heart muscle can be determined using a blood test. The presence of cardiac enzymes in the blood indicates a heart attack.
  • CT or MRI of the heart. They provide detailed images of the heart and chest. This helps the doctor to easily diagnose the problem. The images clearly show the extent of damage from a heart attack.

Modern treatments

After making a diagnosis, the doctor immediately takes measures to solve the problem using the following procedures:

  • Angioplasty – This procedure is done to remove plaque in the blood vessels and helps open a blocked artery using a thin, balloon-tipped tube.
  • Stenting – An artery is kept open after angioplasty by inserting a wire mesh tube called a stent into the artery.
  • Heart bypass surgery – This surgery is done to direct blood flow around the blocked arteries.

Some medications also help treat a heart attack, such as:

  • nitroglycerin – it is administered to open blood vessels and improve blood flow to the heart, in addition, it relieves chest pain;
  • blood thinners such as antiplatelet agents and anticoagulants;
  • painkillers;
  • preparations for the destruction of clots;
  • medicines for high blood pressure.

Prevention of heart attack in women at home

As a woman gets older, it is important to be aware of the risk factors that may affect the risk of developing coronary heart disease. The more risk factors, the higher the chances of a heart attack. Risk factors include:

  • high blood pressure;
  • high blood cholesterol;
  • diabetes;
  • smoking;
  • excess weight;
  • insufficient physical activity.

Identifying risk factors and managing them early can help reduce your risk of a heart attack in the future. All women over 40 need to see a general practitioner for a health check. You should check your risk of developing cardiovascular pathologies every 5 years, monitor your blood pressure and cholesterol levels.

Popular questions and answers

Answered questions about heart attacks in women Cardiologist Natalya Gavrilyuk.

Who has a heart attack more often – men or women?

Women have a lower risk of developing myocardial infarction than men. Women are much more likely to complain of chest pain, which may not be related to the heart, so they go to the doctor more often and, as a result, get sick less often. However, they also have myocardial infarction.

At what age do women have the highest risk of a heart attack?

The risk of myocardial infarction increases with age, especially after menopause. But the specific age for each woman will be different, based on a combination of risk factors – obesity, smoking, diabetes and genetics.

Do not forget that in some conditions, for example, with very high cholesterol numbers in people with familial dyslipidemia or thrombophilia, a heart attack can occur at a young age. Therefore, close relatives of patients who have had myocardial infarction at a young age should be examined as early as possible.

What are the consequences of a heart attack in women?

Postponed myocardial infarction is a whole range of consequences, the range of which depends on the size of the “scar”. In some cases, you can even remain disabled due to reduced performance.

Can a heart attack go away on its own?

A heart attack can pass on its own, but it is important to do the maximum so that the “scar” and the consequences are minimal – this is the key task of medicine. It is now being successfully implemented with the help of modern surgical and medical interventions. Therefore, it is absolutely wrong in the 21st century to endure a heart attack “on the legs”.

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