Everything you need to know about Heart Attack in Women

Heart Attack in Women: Understanding Unique Symptoms, Causes, & Treatment in Dubai

For too long, the classic image of a heart attack has been dominated by male-centric symptoms: a sudden, crushing chest pain radiating down the left arm. However, this narrow perception has tragically led to a significant oversight in women's cardiovascular health. Heart attacks in women often present differently, with more subtle, varied, and sometimes easily dismissed symptoms, leading to delayed diagnosis and treatment. In a vibrant and diverse city like Dubai, where varied lifestyles and increasing awareness of health are paramount, it's crucial for women and their families to recognize these distinct signs and understand the specific risk factors and management approaches for female heart health. This comprehensive guide aims to shed light on the often-misunderstood landscape of heart attacks in women, empowering you with the knowledge to protect yourself and your loved ones.

The Alarming Reality: Heart Attack in Women

Heart disease remains the leading cause of death for women globally, surpassing all cancers combined. Despite this, women are more likely to experience delays in seeking medical help for heart attack symptoms and may receive less aggressive treatment compared to men. This disparity is often attributed to:

• Atypical Symptoms: Women's heart attack symptoms can be less "dramatic" and often mistaken for other conditions like indigestion, anxiety, or fatigue.
• Misconceptions: Both women and healthcare providers may sometimes overlook heart disease as a primary concern for women, focusing instead on reproductive health or other conditions.
• Biological Differences: Women's smaller arteries and the impact of hormonal changes (especially after menopause) can influence how heart attacks manifest.

Understanding these nuances is the first critical step toward improving outcomes for heart attack in women.

What Are the Symptoms of a Heart Attack in Women?

While chest pain or discomfort is the most common symptom for both men and women, women are significantly more likely to experience a range of atypical symptoms that may not immediately be recognized as heart-related. These can appear hours, days, or even weeks before a heart attack.

Common Heart Attack Symptoms in Women:

According to the American Heart Association, heart disease accounts for 1 in 3 deaths in women, and nearly half of all women with heart attacks have a short life span.

1. Unusual or Extreme Fatigue: This is often the most reported symptom in the weeks leading up to a heart attack. It's a profound, sudden tiredness that doesn't improve with rest, even from simple activities like walking across a room.
2. Shortness of Breath: Feeling breathless, even without exertion, or having difficulty breathing, sometimes accompanied by chest discomfort. It can feel like you've run a marathon when you haven't moved.
3. Pain or Discomfort in Other Upper Body Areas: Unlike the classic left arm pain, women are more likely to experience pain or discomfort in:
   • The back: Often between the shoulder blades, feeling like pressure or a dull ache.
   • The neck: A general ache or tightness.
   • The jaw: Can feel like a toothache or a tight band around the jaw.
   • One or both arms: Can be in either arm, not just the left.
4. Nausea, Vomiting, or Stomach Pain: These symptoms can mimic indigestion, heartburn, or the flu. Some women report intense abdominal pressure that feels like an "elephant sitting on their stomach."
5. Lightheadedness or Dizziness: A sudden feeling of wooziness or nearly fainting.
6. Sweating: Breaking out in a cold, clammy sweat, often described as a "stress sweat," unrelated to physical activity or ambient temperature.
7. Sleep Disturbances: Difficulty falling asleep, frequent waking, or feeling tired despite adequate sleep, in the weeks before an attack.
8. Anxiety or a Sense of Impending Doom: Some women report an overwhelming feeling that something is deeply wrong, without a clear reason.
9. Chest Discomfort (rather than severe pain): While chest pain can occur, it may feel more like:
   • Pressure or fullness.
   • Squeezing or tightness.
   • Aching, rather than sharp pain.
   • It may be mild and come and go.

It is thus advisable to never ignore any such atypical symptoms and seek medical attention urgently. Delayed diagnosis and treatment can increase the risk of complications and death.

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"Silent" Heart Attacks in Women:

A significant concern for women is the occurrence of "silent" heart attacks, also known as silent myocardial infarction (SMI). These heart attacks have minimal, vague, or no symptoms at all, making them easy to miss. Despite the lack of obvious signs, a silent heart attack still causes damage to the heart muscle and carries the same risks for future cardiovascular events as a symptomatic heart attack. Women, particularly those with diabetes, are more prone to silent heart attacks due to potential nerve damage that reduces pain perception.

What Causes a Heart Attack?

A heart attack, medically known as a myocardial infarction, occurs when the blood flow to a part of the heart is blocked, usually by a blood clot. This blockage prevents the heart muscle from getting enough oxygen, leading to the death of heart cells in that area.

The primary cause of heart attacks is Coronary Artery Disease (CAD), where the arteries supplying blood to the heart (coronary arteries) become narrowed and hardened by the buildup of plaque (atherosclerosis).

Key Causes and Contributing Factors:

1. Atherosclerosis: The most common cause. Over time, fatty deposits (plaque) accumulate inside the coronary arteries, narrowing them. This process can start early in life and often has no symptoms until the arteries are significantly blocked.
2. Blood Clot Formation: A plaque can rupture, causing a blood clot to form at the site. This clot can completely block blood flow through the artery, leading to a heart attack.
3. Coronary Artery Spasm (Prinzmetal's Angina / Vasospastic Angina): A severe squeezing of a blood vessel that isn't necessarily blocked by plaque. This spasm temporarily cuts off blood flow to the heart muscle.
4. Spontaneous Coronary Artery Dissection (SCAD): A rare but life-threatening condition where a tear forms in the inner layer of a heart artery. Blood leaks through this tear, causing a bulge that can block blood flow. SCAD is more common in women, especially those who are pregnant or have recently given birth, and those with certain underlying conditions.
5. Other Less Common Causes: Certain infections (like COVID-19 can damage heart muscle), extreme emotional stress, or significant physical exertion.

Unique Risk Factors for Heart Attack in Women:

While many traditional risk factors for heart disease apply to both genders (e.g., high cholesterol, high blood pressure, diabetes, smoking, obesity, family history), some factors are more prevalent or impact women more severely, increasing their risk of a heart attack.

1. Diabetes: Women with diabetes are at a significantly higher risk of heart disease and heart attacks than men with diabetes. Diabetes can also alter pain perception, increasing the likelihood of silent heart attacks.
2. Menopause: The decline in estrogen levels after menopause plays a crucial role in increasing heart disease risk. Estrogen is thought to have a protective effect on blood vessels. Lower estrogen can lead to increased cholesterol levels and the development of small vessel heart disease (coronary microvascular disease).
3. Emotional Stress and Depression: These can affect women's hearts more than men's. Stress can cause arteries to tighten, and depression can make it harder to maintain a heart-healthy lifestyle.
4. Smoking: Smoking is a greater risk factor for heart disease in women than in men, even with less exposure.
5. Pregnancy Complications: Conditions like preeclampsia (high blood pressure during pregnancy) or gestational diabetes can increase a woman's long-term risk of developing high blood pressure, diabetes, and heart disease.
6. Certain Autoimmune and Inflammatory Diseases: Conditions like lupus, rheumatoid arthritis, and scleroderma, which are more common in women, can increase the risk of heart disease due to chronic inflammation.
7. Small Vessel Heart Disease (Coronary Microvascular Disease - CMD): Women are more prone to blockages or dysfunction in the very small arteries that branch off the main coronary arteries. Traditional angiography might not detect these blockages, leading to misdiagnosis.
8. Lack of Physical Activity: A sedentary lifestyle is a major risk factor.
9. Family history of heart disease:

Diagnosis of a Heart Attack in Women:

Given the atypical symptoms, diagnosing a heart attack in women requires heightened awareness and thorough evaluation.

1. Electrocardiogram (ECG/EKG): Records the electrical activity of the heart to detect abnormalities that indicate heart damage or a lack of blood flow.
2. Blood Tests (Cardiac Enzymes): Measures levels of certain proteins (e.g., troponin) that are released into the bloodstream when heart muscle is damaged. These are crucial for confirming a heart attack.
3. Chest X-ray: To check for fluid in the lungs (a sign of heart failure) or other conditions that might mimic heart attack symptoms.
4. Echocardiogram: Uses sound waves to create images of the heart's structure and function, showing how well the heart is pumping and if any areas are damaged.
5. Coronary Angiography (Cardiac Catheterization): A definitive test where a catheter is threaded through a blood vessel to the heart, and dye is injected to visualize the coronary arteries and identify blockages. This is essential for determining the need for interventions like angioplasty.
6. Cardiac CT Scan or MRI: Can provide detailed images of the heart and blood vessels, especially useful in evaluating the heart muscle and large arteries.
7. Stress Test: May be performed if symptoms are not acute but raise suspicion of underlying heart disease. It evaluates how the heart performs under stress (exercise or medication-induced).

Treatment Options for a Heart Attack:

Immediate medical attention is crucial for a heart attack, regardless of gender. Treatment aims to restore blood flow to the heart, minimize damage, and prevent future events.

Emergency Treatment (Immediate Actions):

• Call Emergency Services: Do not drive yourself. Immediate professional medical help is vital.
• Aspirin: Chewing aspirin (if not allergic and advised by emergency personnel) can help prevent further blood clotting.
• Oxygen Therapy: To ensure adequate oxygen supply to the heart.
• Pain Medication: To alleviate severe discomfort.

Post-Heart Attack Care and Rehabilitation:

• Cardiac Rehabilitation: A supervised program that includes exercise training, education about heart-healthy living, and counseling to reduce risk factors and improve recovery.
• Medication Management: Long-term use of medications to control cholesterol, blood pressure, blood sugar, and prevent clotting.
• Lifestyle Modifications: Essential for preventing future heart attacks.

Prevention of Heart Attack in Women:

Prevention is key, especially given the unique risk factors for women.

1. Know Your Risk Factors: Understand your personal risk based on family history, existing conditions (diabetes, high blood pressure), and lifestyle. Get regular health check-ups in Dubai to monitor blood pressure, cholesterol, and blood sugar.
2. Healthy Diet: Adopt a heart-healthy eating pattern.
   • Focus on: Fruits, vegetables, whole grains, lean protein (fish, poultry), and healthy fats (avocado, olive oil, nuts).
   • Limit: Saturated and trans fats, processed foods, added sugars, and excessive sodium.
3. Regular Physical Activity: Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week, plus muscle-strengthening activities at least two days a week.
4. Maintain a Healthy Weight: Losing even a few kilograms can significantly reduce heart attack risk.
5. Quit Smoking: If you smoke, quitting is the single most impactful step you can take for your heart health. Seek support if needed.
6. Manage Stress and Depression: Engage in stress-reducing activities like meditation, yoga, mindfulness, or connect with support groups. Seek professional help for depression.
7. Manage Chronic Conditions: Diligently control blood pressure, blood sugar (for diabetics), and cholesterol levels through lifestyle and medication as prescribed by your doctor.
8. Get Adequate Sleep: Aim for 7-9 hours of quality sleep per night, as poor sleep can increase heart disease risk.
9. Regular Check-ups: Ensure you have regular medical check-ups in Dubai to screen for heart disease risk factors.

Fakeeh University Hospital: Dedicated to Women's Heart Health in Dubai

At Fakeeh University Hospital in Dubai, we recognize the critical importance of understanding and addressing the unique aspects of heart attack in women. Our comprehensive Heart Institute is committed to providing specialized, compassionate, and advanced cardiac care for women of all ages.

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In this heartfelt video, a female patient shares their experience receiving advanced cardiovascular care at Fakeeh University Hospital.

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Don't ignore subtle symptoms or delay seeking help. Your heart health is invaluable.

If you experience any symptoms that concern you, especially the atypical signs discussed, seek immediate medical attention. For comprehensive heart health assessments, preventive care, or specialized consultations in Dubai, contact Fakeeh University Hospital today to book an appointment with our Best Cardiologists in Dubai. We are here to empower women with optimal heart care.

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