ESBProfessional/ShutterstockWomen tend to have heart disease without blockages in big arteries, according to Holly Andersen, MD, Director of Education and Outreach at the Ronald O. Perelman Heart Institute at New York-Presbyterian Hospital/Weill Cornell Medical Center. For that reason, heart attack symptoms in women look different as well, which is why doctors often miss—or misdiagnose—heart attacks in women, especially younger women. The good news is doctors are getting better: Women used to be twice as likely to die from a heart attack as men; now, the gap has narrowed and women’s chances of survival are almost as good as a man’s.
Whereas the classic symptoms of heart attack include chest pain, lingering chest discomfort/heaviness, pain in one or both arms, shortness of breath, and excessive sweating, the majority of women experience none of these, according to recent research out of George Washington University. Because the signs of heart attack in women are so different from those in men, they’re more easily missed by doctors, and since most heart attack deaths happen within an hour of symptoms first presenting themselves, it’s not surprising that women have historically had a poorer survival rate than men when it came to heart attacks.
But it looks as if science may be catching up to the gender difference, at least according to research presented by Dragana Radovanovic, MD, head of the AMIS Plus Data Centre, University of Zurich, Switzerland, at the 2017 annual gathering of the members of the European Society of Cardiology, a not-for-profit society of medical professionals. Dr. Radovanovic was reporting on a study of in-hospital mortality rates for heart attack patients, which involved 50,000 people from 33 Swiss hospitals over a 20-year period.
Dr. Radovanovic’s data showed that heart attack mortality rates over the past two decades have dropped for both men and women, but especially for women. In one population of heart attack patients, the mortality rate dropped from 9.8 percent to 5.5 percent in men and from 18.3 percent to 6.9 percent in women. “Although in-hospital mortality continues to be higher in women than men, overall age-adjusted mortality has decreased more prominently in women compared to men,” Dr. Radovanovic told Science Daily. Although the data also showed that younger women are more likely to die from heart attack than older women, the decreasing gender gap in mortality is even more prominent in the young. So it appears that progress is continuing to be made in identifying the signs of heart attack in young women, in particular.
Dr. Radovanovic theorizes that the decreasing gender gap may be attributable to advances in treatment options. For example, during the 20-year study period, hospitals treated more and more heart attack patients with a crucial “percutaneous coronary intervention.” In one group of patients included in the study, the use of PCI increased from 60 percent to 93 percent in men, and from 45 percent to 90 percent in women. The reason for this could very well be that doctors are more aware of the gender differences in heart attack symptoms and therefore more able to identify when a woman is having a heart attack.
The thing to remember is that heart disease is the number one cause of death in the United States—this year, about 735,000 Americans will have a heart attack—so make sure you can recognize the symptoms. This infographic shows heart attack symptoms in women can vary depending on race. And here are some chest pains you might mistake for a heart attack.