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Fatigue, indigestion, upper back pain – such common symptoms can easily be dismissed as nothing serious. However, for women these can surprisingly be signs that your heart is in distress.

According to Dr Adriano Dello Iacono, a cardiologist practising at Netcare Pinehaven and Netcare Olivedale hospitals, there is a general misconception that coronary artery disease is a male health issue. He warns that the lack of awareness around heart attack symptoms in women is dangerous. 

“International data has shown that even amongst doctors, there is a misconception that women are not affected by heart disease. This leads to certain symptoms being overlooked – like indigestion and fatigue – with the result that heart attacks in females can all too easily be missed,” he says.

Dr Dello Iacono highlights that after menopause, a woman’s risk factors for heart disease are in fact equivalent to those of a man. “This does not mean that younger women are home free, however. Research shows that the increase in heart attacks among adults between the ages of 35 and 54 is particularly noted in women.

“Modern lifestyle choices play a significant role in higher rates of heart attacks in these age groups. Younger people have a greater likelihood of consuming energy drinks, fast foods and processed meals – all of which contribute to coronary artery disease. There has also been an increase in tobacco use amongst women in the past ten years than was previously documented,” he says.

Furthermore, while males still tend to have a higher incidence of heart attacks than females overall, certain coronary diseases, such as spontaneous coronary artery dissection (SCAD) – the formation of a tear in the artery wall – can be higher in females, particularly during pregnancy.

What to look out for

Dr Dello Iacono explains that while the classic red flag of chest pain occurs in both sexes, there are other less obvious symptoms experienced by women, which may be easily overlooked. These can include: 

• Nausea and vomiting
• Indigestion
• Pain in the upper abdomen or lower chest area
• Sudden or extreme fatigue
• Upper back or left shoulder pain

“Risk factors in women can also differ from those in men, though lifestyle factors play an overarching role. Pregnancy can be a risk factor for certain rare conditions, such as the worsening of blood pressure in the vessels that supply the lungs (pulmonary hypertension), the enlargement of the base, or root, of the aorta and SCAD.

“Women can also be more likely to develop heart disease due to having Takotsubo cardiomyopathy, or broken heart syndrome, which is a sudden weakness in the heart muscle brought on by acute stress. From a healthcare perspective, this usually presents as a heart attack.”

“Healthcare professionals should always consider the possibility of a cardiac event, even in the absence of chest pain, especially in patients with cardiac risk factors and when symptoms don’t fit another clinical picture. If there is any question that a heart attack could be present, it is best to err on the side of caution and conduct the necessary tests,” he advises.

Prevention is key for women too

Dr Dello Iacono points out that while certain heart conditions can occur fairly abruptly, screening remains one of the foremost preventative care measures that should ideally start at a young age, and certainly after the age of 40. Regular blood pressure, finger prick cholesterol, and blood sugar screening are key in early risk factor identification for women and men.

To reduce the risk of a heart attack, the following risk factors must be kept under control:

• Diabetes
• Hypertension
• Dyslipidaemia (unhealthy levels of certain fats in your blood)

“It is vital that women consider their heart health from a young age. The earlier you start to exercise regularly, maintain a healthy body weight and eat a healthy diet, the more your risk will be reduced. Importantly, smoking must be avoided,” he says. 

What to expect when recovering from a heart attack

According to Dr Dello Iacono, whether male or female, patients recovering from a heart attack must get plenty of rest, avoid stress as much as possible, eat a heart-healthy diet, quit smoking if they are smokers, and recommence physical activity under the guidance of their doctor.

“It is important to be aware that recovery is determined by the severity and extent of damage caused during a heart attack, the type of artery involved and the time from onset of symptoms to restoration of blood flow. Every patient is different, and certain complications can occur at various stages of recovery.

“Certain medications and other rehabilitative therapies may be required. Careful weight management and the proper management of diabetes and hypertension are imperative for people with co-morbidities,” he concludes.

Ends.

Notes to editors
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