Thursday, February 26 2015 3:26

Female Hearts Are Different

Written by Dr. Jeanine Romanelli, Lankenau Heart Institute

Knowing the Difference Can Save a Life

Women are different from men in many ways, and it may be surprising to learn that hearts and heart health are important differences. Still, it’s true.

Research has found that women have their own unique set of heart disease symptoms and prevention tactics that are completely separate from men’s. Plus, risk factors affect women differently than men—too often, the risks are worse for women.

Although efforts to raise awareness about women’s heart health have increased recently, heart disease remains the leading killer of women each year, taking more lives than cancer—that’s all forms of cancer—plus Alzheimer’s disease and other accidents combined. With statistics like this, women simply can’t afford to ignore their heart health.

Fortunately, by taking charge of their health and understanding their risks early, women can help substantially lower their risk for heart disease.

Different Risk Factors

Some risk factors for heart disease are shared by both women and men, including smoking, high blood pressure and high cholesterol, obesity, inactivity and a family history of heart disease.

But there are other, less-discussed factors that are specific to women. For example, after menopause, a woman’s risk of heart disease may increase. Taking oral estrogen does not reduce this risk—in fact, it may actually increase it. Also, women are more likely to suffer heart failure during pregnancy and also as a result of stress in their lives, which can make them more susceptible to heart disease.

Although diabetes is a risk factor for both men and women, it’s a greater risk for women. According to the American Diabetes Association, women are more likely to develop diabetes than men, and women with diabetes are five times more likely to develop heart disease than women without it, while the heart risks for men with diabetes are only doubled.

Women may also be diagnosed with gestational diabetes, a specific condition that develops during pregnancy. While this issue does disappear after pregnancy, it can raise a woman’s risk for diabetes later in life. Add to the risks that developing hypertension during pregnancy may also increase the risk of developing hypertension later in life. It’s a lose-lose.

Different Symptoms

Would you call 911 if you were having a heart attack? Unfortunately, only 50 percent of women answer “yes” to that question. Although women are becoming increasingly aware that their heart attack symptoms differ from the classic symptoms we know for men—crushing chest pain, sharp left arm pain, shortness of breath—many women are less likely to act when they think they may be having a heart attack.

If you notice subtle symptoms like fatigue, indigestion, shortness of breath, left or right arm pain, anxiety or loss of appetite, these are all symptoms of a heart attack in women. Don’t wait for chest pain—women don’t always have it—and don’t wait until you feel better. Call 911 immediately! Too many women come into their doctor’s office well after suffering a heart attack. The faster the treatment, the better.

Similar Prevention

As women, we’re busy, but there are still steps we can take to make heart health a priority. Living an active lifestyle is one of the most important things you can do to combat heart disease, and this simple, though not necessarily easy step, can make a big difference. Unlike risk factors you can’t control—age, race, family history—adequate exercise should be on your To-Do list!

A middle-aged woman who doesn’t exercise for at least one hour each week isn’t just increasing her risk for heart disease, she is doubling it. The best strategy is to find ways to fit activity into your schedule by choosing exercises you enjoy. Whether it’s dancing with your children as you cook dinner or taking weekend walks with your spouse or friends, find time to make exercise a regular part of your life.

It’s important to practice heart-healthy habits at every point during your life, but pregnancy and menopause can make women especially vulnerable to risk factors like weight gain, diabetes, high blood pressure and high cholesterol. Pay close attention to practicing healthy habits during these times, and work with your doctor to closely monitor your heart health.

In addition to these unique risk factors, both women and men can lower their heart disease risk by quitting smoking and monitoring blood pressure, cholesterol levels and weight.

Tests and Talks

To help lower heart disease risk, it’s important for women to talk openly to their doctors about their individual risk factors, lifestyle habits, questions or concerns about heart disease. Taking a daily aspirin is recommended only for some women, so, again, it’s best to talk with your doctor.

Depending on your health history, your doctor may suggest certain health screenings—electrocardiogram (ECG), cardiac computerized tomography (CT) scan—or refer you to a specialist who can help you closely monitor your heart health.

You only get one heart. It’s worth knowing how to protect it.

Jeanine Romanelli, M.D., is a board-certified cardiologist with Lankenau Heart Institute, part of Main Line Health. Lankenau Heart Institute is proud to be home to the largest team of female cardiologists in the region. To make an appointment with a Lankenau Heart Institute cardiologist or to learn more, visit

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