It’s a common scenario. A woman in her fifties wakes up feeling nauseous. Rejecting him, she goes through her day, feeling a little tired during her morning walk, even out of breath. Her friends are urging her to go to the doctor after feeling a stabbing pain in her arm. Although she thinks it’s nothing, she goes to the emergency room where she undergoes a battery of tests. She is told that there is no blockage in any of the three main arteries, and instead she may have a stomach problem or anxiety, and is sent home.
There is no major blockage, no chest pain. It couldn’t be a heart attack, right?
For years, the above scenario wouldn’t have warranted a second thought. This is because our understanding of heart attacks was, until recently, primarily based on men. And when men have heart attacks, they have chest pains due to blockages in the heart arteries.
Doctors are now learning how different heart attacks and heart disease can be in men and women. “Broken heart syndrome,” the name used to describe a temporary condition that occurs when stressful or unexpected situations cause sudden chest pain and tightness, is an example of a lesser-known type of cardiovascular disease that is more common in women than in men.
We spoke with the Yale Medicine cardiologist Erica Spatz, MD, MHS, clinical researcher for the Yale Center for Outcomes Research and Evaluation (CORE), which focuses on health care quality, changing knowledge about women, and heart disease. Read on to learn more and to ensure your health and the health of others, don’t miss these Sure signs you’ve already had COVID.
Yes. Hormone cycles can affect women’s cardiovascular health. In the pre-menopausal years, estrogen protects the heart – estrogen relaxes the arteries and promotes good cholesterol. In the peri-menopausal years, however, as estrogen declines, there is an emergence of cardiovascular risk factors such as high cholesterol and hypertension, including in women who previously had low cholesterol and normal or even low blood pressure. The incidence of heart disease in women begins to increase around age 65, about 10 years later than in men, likely due to the protective effects of estrogen.