Cardiovascular disease remains the leading cause of death for women globally, yet it is often understudied, underdiagnosed, and undertreated. Experts note that women are nearly 50% more likely than men to be misdiagnosed after a heart attack, partly because the symptoms can differ significantly.
Dr. Sorcha Allen, a Consultant Cardiologist, explained on the ‘Her Health’ podcast series that historical clinical trials predominantly focused on men. This has led to a medical understanding and training based on a male presentation of heart disease, often characterized by central chest pain radiating to the jaw or left arm, primarily in men over 55. Consequently, heart disease has been perceived as a 'male issue,' in contrast to conditions like breast cancer or menopause, which are more commonly associated with women.
Dr. Allen emphasized that the term "atypical" symptoms for women is misleading, as these presentations are entirely typical for a significant portion of the population. Subtle symptoms, which can be easily overlooked or misattributed, are common in women. Profound fatigue and a reduced ability to exercise are frequently observed. Shortness of breath and sleep disturbances, particularly in the two weeks preceding a cardiac event, are also highly prevalent.
When women do experience chest discomfort, they may describe it as a band-like pressure or even indigestion rather than crushing pain. These symptoms can be dismissed by healthcare providers and attributed to anxiety, gastrointestinal problems, or musculoskeletal issues, leading to delayed diagnosis and potentially worse long-term outcomes.
To combat this, Dr. Allen suggests three key actions for women:
First, regular blood pressure checks are crucial, and high readings should be managed, not dismissed as "white-coat hypertension."
Second, women should discuss their family history of early heart disease, any pregnancy complications, and autoimmune or inflammatory conditions with their doctor.
Third, maintaining a healthy lifestyle is vital. This includes focusing on whole, fresh foods about 80% of the time while avoiding ultra-processed options. For exercise, consistency is emphasized, with brisk walking for 20 to 30 minutes five times a week being highly beneficial. Incorporating weight-bearing or resistance exercise is also recommended to maintain bone and muscle health.
Most importantly, Dr. Allen urges women to listen to their bodies and advocate for themselves. Women often minimize their symptoms due to caregiving responsibilities for children, careers, or aging parents. If symptoms like exhaustion, breathlessness, or a general feeling of being unwell persist, they should not be ignored. Seeking a second opinion if concerns are not adequately addressed by a healthcare provider is also encouraged, as ruling out serious cardiac issues is always a prudent step.