For many years, heart disease has been seen as a problem that mainly affects men. But the reality is very different. Cardiovascular disease is actually one of the leading causes of death among women worldwide. Yet, women’s heart symptoms are often overlooked, sometimes by patients themselves and sometimes even in medical settings.
One important reason is that heart disease does not always look the same in women as it does in men. Most people imagine a heart attack as sudden, severe chest pain spreading to the left arm. While this is a classic symptom, women often experience heart problems in a much less obvious way.
Instead of severe chest pain, women may notice symptoms such as unusual fatigue, breathlessness, nausea, dizziness, discomfort in the back or jaw, or a feeling similar to indigestion. Because these symptoms seem mild or unrelated to the heart, many women delay seeking medical attention. Unfortunately, that delay can sometimes be dangerous.
Recent research, published in a journal of the American Heart Association, highlights another interesting difference between men and women when it comes to heart disease. In a study involving more than 4,000 patients with chest pain, doctors found that women often had less visible blockage in their heart arteries compared to men. In fact, only about 55 per cent of women showed plaque buildup in their arteries, compared to 75 per cent of men.
However, the surprising finding was this: even with less blockage, women still had nearly the same risk of serious heart problems, including heart attack or hospitalisation. This tells us something important, heart disease in women may not always be about large blockages in themajor arteries.
Women are more likely to have problems in the smaller blood vessels of the heart, a condition sometimes called microvascular disease. These tiny vessels can affect blood flow to the heart muscle but may not always appear clearly in routine tests. In simple terms, a woman’s heart can still be at risk even when major arteries do not look severely blocked. Hormones also play a role. Before menopause, estrogen provides some protection to the heart. But after menopause, this protection decreases, and the risk of heart disease rises significantly.
Comorbidities
There are also certain risk factors that affect women more strongly. Diabetes, for example, increases heart risk more in women than in men. Pregnancy-related conditions such as high blood pressure during pregnancy or gestational diabetes can also increase long-term heart risk later in life. Stress and mental health also appear to play a bigger role in women’s heart health. All of this means that awareness is extremely important.
Women should not ignore symptoms like persistent tiredness, unexplained breathlessness, or discomfort in the chest, jaw, or back, especially if these symptoms appear suddenly or during physical activity. At the same time, prevention remains the most powerful tool we have. Regular health check-ups, controlling blood pressure, maintaining healthy cholesterol levels, managing diabetes, staying physically active, and avoiding smoking can significantly reduce the risk of heart disease. Healthy eating and maintaining a healthy weight are also important steps in protecting the heart.
The key message is simple: heart disease in women may look different, but the risk is just as real. Recognising the warning signs early and taking preventive steps can save lives. When it comes to heart health, women should remember that symptoms do not always have to be dramatic to be serious. Listening to your body and acting early can make all the difference.
(The writer, Dr Aravind Duruvasal, is a consultant interventional cardiologist at Prashanth Hospitals, Chennai)