Heart disease – it’s different for women

Heart disease – it’s different for women

Would you know if you had a heart problem? It’s not always as clear cut as you might think says our health editor Patsy Westcott

Would you know if you had a heart problem? It’s not always as clear cut as you might think says our health editor Patsy Westcott.

Seven years ago I spent a week in hospital following a bout of chest pain - not an experience I’m in a hurry to repeat. But it did get me wondering about the differences between men and women’s hearts. Here’s what I discovered…

First the bad news: once we reach a CERTAIN age we do become more prone to heart problems.

The good news is that, after years of lumping women and men together, experts are at last learning about the differences between the way men and women’s hearts work, and this in turn is leading to better diagnosis and treatment.

Before menopause plentiful supplies of the female hormone, oestrogen, which has antioxidant and anti-inflammatory properties, plus progesterone, the other big female hormone, help protect our heart and blood vessels and keep us healthy. 

During our 50s dwindling levels of these same hormones rob us of that protection and we become vulnerable to the same risk factors as men – high levels of ‘bad’ LDL cholesterol, high blood pressure, high levels of other blood fats called triglycerides and diabetes all of which rise post-menopause.

That’s why it’s vital for all of us to make an effort to stay heart healthy by…

  • Watching our weight (and waist), eating a heart-healthy Mediterranean diet.
  • Taking regular exercise and managing stress.
  • Taking advantage of the free NHS health check offered to all of us every five years between ages 40 and 74 years.
  • Talking to the doctor about the pros and cons of HRT – hormone replacement therapy – which is heart-protective in the early years post-menopause. (I’ll be looking at this in future articles.)

The other good news is that doctors are also learning more about the different causes and symptoms of heart problems in women.

It’s now known that women are more prone to something called coronary microvascular dysfunction (CMD), which affects the small blood vessels serving the heart, rather than furring and narrowing of the large coronary arteries (atherosclerosis) that usually affects men.

This is a key reason why women are more prone to ‘silent’ heart attacks without the classic gripping chest pain we’re familiar with from TV and movies. Instead women who have a heart attack experience vaguer, more subtle symptoms – things like abdominal pain, shortness of breath, fatigue and back and neck pain. Being aware of this can enable us to seek help early. Never be afraid to bother the doctor even if you just vaguely feel something ‘isn’t quite right.’

As for me, fortunately my ‘heart attack’ proved a false alarm and I was discharged with a clean bill of health.

However it did make me determined to take extra care of my heart. I love cooking and experimenting with the veg-rich cuisines of Spain, Greece, Italy and other countries around the Med. Also the one time in my day that’s sacrosanct is my exercise slot. Zumba, charleston, salsa, walking and a fab 30-minute women-only circuit at my local gym are all ways I try to stay heart-fit. I’m also a great fan of bedtime and try to get eight hours shut-eye most nights, as well as making time to rest, relax and have fun. 

Nobody’s perfect of course and I do slip off the straight and narrow from time to time. When that happens I try not to beat myself up about it – after all a little of what we fancy does us good provided we get back on track at the next opportunity.

See my previous Victoria article for more heart healthy tips

Could it be a heart attack?

If you are concerned at all, seek urgent medical help.

To be prepared for the unexpected, it’s worth having a look at the British Heart Foundation website for useful advice on symptoms and how to act on any worrying signs. Here is a brief summary.

  • Chest pain or discomfort – the best known though not always present in women
  • Pain radiating to the arms, neck, jaw, stomach and back
  • Feeling of indigestion or reflux type pain – often ignored
  • Feeling sick, sweaty, breathless or lightheaded with associated chest pain or discomfort.
  • A general feeling of being unwell or lethargic accompanied by chest pain or discomfort.

If you experience these call 999 then sit and rest while you wait for help to arrive. Chew an adult aspirin tablet (300mg) if you have one handy (provided you’re not allergic to, or have been told not to take, aspirin). However don’t go searching for one if not as, according to the British Heart Foundation website, this could put additional strain on your heart.

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Not Always

Coco 22/05/2017

The case, so not good to panic women with these symptoms into dialling 999! I have spinal problems and have pain from my neck all the way down to the coccyx, it radiates down my left arm from my shoulder too, all down to slipped discs. I have stomach pain due to a hiatus hernia and occasionally feel nauseous. I do have high BP and am on medication for it though, so I'd say make sure you go for a yearly check-up at your surgery with the nurse.

Neck pain warning


My Mum still worked at 75. She had been at work earlier on the day she had a massive heart attack which was to take her from us 2 days later without regaining consciousness. For the 2 weeks prior to this she complained of terrible neck pain. Her doctor said it was arthritis! If you are worried about anything ask to see a specialist it may save your life.

Felt my heart was going to pop

audnay 16/02/2017

My heart played up a few years ago,I had an idea something was wrong?? I was at work, and would get short of breath and twinges, my lips had a tinge of blue,and always so tired,it affected my job. I went to Leeds hospital had a scan on my heart. I was given some radioactive stuff, It was weird, was chatting away one minute, and as the injection worked I felt I had an elephant on my chest,then other injection was given in the other arm to stop it, I thought my heart was going to pop, I take meds.

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