Article contributed by the Department of Cardiology from National Heart Centre Singapore (NHCS), a member of the SingHealth group.

Heart disease doesn’t happen primarily to men.

The truth is, cardiovascular disease is the leading cause of death in women too, and female patients, particularly young women, have a worse outlook from heart attacks than their male counterparts.

However, men and women experience cardiovascular disease in different ways, with women exhibiting fewer common symptoms and responding to treatment in a different way. Women may also experience a different kind of heart disease that affects heart muscle or the small blood vessels that supply the heart.

Symptoms of a heart attack in women

For both men and women, the most common symptom ​of a heart attack is chest pain or discomfort, described as an achy, tight or “heavy” feeling.

However, a study featured in the Journal of the American Medical Association, found that women are more likely than men to have heart attacks that present without chest pains, and they are more likely to die of a heart attack than men.

Women are more likely than men to experience other signs of a heart attack. These include:

  • Shortness of breath
  • Nausea
  • Feeling faint
  • Breaking out in a cold sweat
  • Pain in the arms, back, neck, jaw or stomach.

They may also have less common signs of a heart attack, such as:

  • Heartburn
  • Feeling tired
  • A cough
  • “Heart flutters”

Women may sometimes discount these clues as they don’t “feel” like a heart attack. However, it is important that these warning signs are not ignored and that a doctor be consulted immediately.

Risk factors of heart disease in women

When it comes to cardiovascular disease, women have some inherent risk factors. These include:

  • Age: Risk increases wit​​​​h age, especially after menopause.
  • Family: The risk is higher if a direct family member develops heart disease before 55 years for male relatives, or 65 years for female relatives.
  • Gender: Women usually experience heart attacks a decade or so later in life than men, and are more likely to die from them.
  • Ethnicity: In Singapore, ethnic differences in heart disease exist, with higher heart attack rates among Indians and a higher risk of dying from a heart attack among Malays.

Other risk factors, which are the same for males and females, can be managed with lifestyle modifications and medications. They include:

  • Smoking – Smoking increases the risk of a heart attack by two to three times; it causes more plaque to form and become unstable.
  • Diabetes
  • Cholesterol – High levels of LDL (“bad”) cholesterol or low levels of HDL (“good”) cholesterol increase the risk of coronary disease.
  • Hypertension​
  • Obesity – Being overweight increases the levels of LDL cholesterol.

See next page for ​information on diagnosis, treatme​nt and prevention tips for heart attack in women​.



Ref: T12