Affairs of the Heart Are Not Always About Love

This article has been re-posted from my content on

“9-1-1. What’s your emergency?”  No one wants to be on the calling end of that one, and yet cardiovascular disease (CVD) remains the #1 Killer for both men and women alike. Myocardial Infarction, or MI, is the clinical term for a heart attack, which may be mild to fatal, and nothing to mess around with. A heart attack occurs when a clot forms around loosened plaque buildup in one of the main arteries that provides blood supply to your heart and occludes it, preventing the heart from receiving the oxygen carried by the blood. The area of the heart that is fed by the damaged vessel dies from the lack of oxygen, and a heart attack has occurred.

Previously considered a man’s disease, women were excluded from studies for many years. When they finally were included, it was shown that men were twice as likely to smoke as women, which further solidified the fairy tale that it was a man’s disease, since smoking is such a big risk factor. Women were traditionally given fewer diagnostic tests and less aggressive treatment than were men, and as a result, developed worsening cardiac problems from inadequate care.

Thank goodness that has changed, well, mostly. It seems that, even now, physicians are less likely to prescribe medications or give post-MI instructions about quitting smoking to women than to men prior to discharge. It appears we still have some work ahead to close the gender gap when it comes to heart attacks.

The mechanism is the same for men and women: blocked arteries to the heart that deprives it of oxygen, causing tissue death. The symptoms are the same, the most notable being chest pain that may or may not be accompanied by shortness of breath, nausea or vomiting, back pain, unexplained fatigue, dizziness, pale color, sweating, radiation to the left (mostly) arm or to the neck, jaw, or shoulder. The chest pain may be a pressure, aching, burning, or “heavy” sensation, or just feel like indigestion, which is why many don’t seek help. The disparity between men and women, and there seem to be differing opinions on this, is that, although women also have classic chest pain, they can also have more subtle symptoms, as those noted above, instead. They are also more likely to have a silent MI, having no symptoms at all.

There are physical differences that can affect the way women experience heart attacks. One is that their hearts are smaller, and they tend to have small vessel disease instead of blockages in the larger coronary arteries. They can still have MIs, but the problem with this kind of CVD is that upon cardiac catheterization, the blockages don’t show up because only the larger arteries are visualized, and patients are sent off with a “clean bill of health”, with unseen dangers in the heart left unidentified.

Women are generally about seven years older than men when they have their first heart attack. This is because premenopausal women still have a good supply of estrogen, which is heart-protective. After menopause, that supply diminishes along with the protection. Endometriosis, polycystic ovary disease, diabetes and high blood pressure complications of pregnancy, and oral contraceptive use, especially if a smoker or overweight, are all risk factors exclusive to women.

This is an extremely important subject, not only for older men and women, but for young people, too, as it is on the rise in younger age groups. Please do your homework. There is so much to know, and you can start with the links in this article. Everyone should know the signs and symptoms of a heart attack. Learn, get help, and save that muscle.