Search for tag: "heart attack in women"

Interviewer: Did you know that when women have heart attacks the symptoms are different from men? True. You're going to find out more about that next on The Scope.

I was surprised to find out that heart attack symptoms are actually different in men and woman. We're going to learn more about that right now with Dr. John Ryan, he's the director of the Dyspnea Clinic at the University of Utah. Men and woman, heart attack symptoms are different, is that true?

Dr. Ryan: It's true to a certain extent, so the traditional concept we have of heart attacks being the crushing chest pain, hand on your chest, sweating, vomiting and presenting to the emergency department and be found to have a heart attack, is seen more commonly in men, however, part of the issue is is that women also experience these, but tend to ignore them more. So yes, they have the symptoms, but they just tolerate them better or dismiss them as being a heart attack, because many women don't feel that they're predisposed to a heart attack.

Interviewer: So for example if you were to ask somebody what kind of pain you're feeling, one person might say it's a level ten, same amount of pain...

Dr John Ryan: Yes, exactly.

Interviewer: ...number five, women are doing the same thing with these symptoms.

Dr. Ryan: Exactly, yeah, so there's a tendency to dismiss the symptoms, so therefore the symptoms often times need to be more severe or more advanced before woman present with them and then by the time they're more severe and more advanced, they're then different, so instead of having left sided chest pain or pain radiating down the left arm, they now have central chest pain and it's radiating down both arms. So that's what ultimately can make the syndromes different. Also, women often don't feel that they should have heart attacks.

Interviewer: They don't have time.

Dr. Ryan: Not only do they not have time, but it's a problem that men have. And this is a serious misconception because cardiac heart disease is the biggest cause of death of women in the United States.

Interviewer: Which is a surprise to a lot of people.

Dr. Ryan: Surprise to a lot of people and it's an important public awareness issue so therefore when women again, when they get their chest pains, or their symptoms from the heart attack, not only do they tolerate it more than men, but also they dismiss it as being a heart attack, sure, sure, why would I be having a heart attack, I'm a woman.

Interviewer: Sure.

Dr. Ryan: I don't have heart disease.

Interviewer: Why do women dismiss, I mean, what is it about a woman's body that they tolerate it more? Any idea?

Dr. Ryan: Probably a pain threshold issue.

Interviewer: We've heard that before.

Dr. Ryan: Exactly, yeah, women often claim to have a higher pain threshold than men, and that's probably true and in this, and that's a very, that's an advantage, but ultimately that ends up hindering people in terms of presenting when they are having their heart attack. So that's probably the issue.

Interviewer: The symptoms are the same but different, they experience them differently, but at the end of the day, are heart attacks different?

Dr. Ryan: So the heart attacks are still associated with significant morbidity, significant mortality and so in that regard they are just as ominous and just as sinister. And the pains, again, the classical pains that people get or that people are taught, is that the central chest pain or the left sided chest pain, radiating down into the left arm, woman often times don't describe this as pain but will describe it as a pressure or a tightness in the chest, all of which are various adjectives that really impact how you perceive pain and again that reflects how you perceive pain. But ultimately the prognosis is still serious, still ominous, and still needs to be treated, taken very seriously and women need to be aware of the fact that they are as likely to experience cardiovascular events as men.

Interviewer: Is there a take away that you would have?

Dr. Ryan: Although we want to see patients when they're having heart attacks, we want to prevent patients from having heart attacks all together, so the more important aspect would be for women to be proactive in order to preventing events, so doing exercise, eating healthy, having heart smart diets and trying to, staying on top of their blood pressure, cholesterol and so on so that we don't end up seeing them when they've had a heart attack.

updated: February 23, 2022
originally published: February 7, 2014

Interviewer: Is it bad enough to go to the Emergency room, or isn't it? Find out now. This is E.R. or Not on The Scope. Time for another edition of E.R. or Not with Dr. Troy Madsen. This is an interesting one: I'm having pains in my chest. E.R. or not?

Dr. Madsen: And that is always a tough question because chest pain is one of the most common things we see in the E.R., and 95% of the time or more, all the testing we do is negative. But it's very concerning because there's that 5% of the time where it's a heart attack, where it's something really serious and it's something you need to come to the E.R. for.
Risk Factors for Heart Disease

Dr. Madsen: So the big thing I base this on is what are your risk factors for heart disease? Because when we think chest pain we think of the heart. If you're someone who is older, let's say over the age of 55, if you're a smoker, you've got high blood pressure, high cholesterol, diabetes, all these things that increase your risk, absolutely you need to come to the E.R. If you're someone who is 25 years old, who was maybe out running, maybe got a little bit tight, maybe coughing a little bit, there, I'm not so concerned. Maybe it was a little bit of asthma, something like that that just caused some tightness in the chest.

So the big thing in my mind is, what kind of risk factors do you have for heart disease, is it a crushing pain that goes up to your neck? Is it causing you to sweat? Does it go down your arm, you feel nauseated, and all these other things that are signs of a heart attack? All good reasons to come to the E.R.

Interviewer: I've had instances where I feel like there's a gas bubble in my chest and it's hard to breathe in deeply.

Dr. Madsen: Yes.

Interviewer: And eventually if you do breathe in deep enough it kind of pops and goes away.

Dr. Madsen: Yeah.

Interviewer: What's that?

Dr. Madsen: It's probably something that's worked it's way up into your esophagus, maybe a little gas bubble up in there that you're feeling over in your chest. Sometimes a lot of causes of chest pain are maybe not causing symptoms exactly like you had, but maybe some kind of a viral illness that can cause some inflammation along the ribs, or along the lining of the lungs. All those can cause these sort of things that cause chest pain. And they're not really that serious.

Interviewer: Is chest pain for a heart attack on the left side, or can it be on the right side?

Dr. Madsen: It's tough. Sometimes, even in older women, it can be abdominal pain. They can have signs of a heart attack where they're actually having pain down in their abdomen and you're thinking, "Oh, maybe they've just got a little bit of food poisoning or a virus." So it's really tough. So that's why it's usually the left side and it's usually going to cause pain to go up and down your neck and your arm and make you sweat. That's a classic heart attack, but I've seen lots of cases of heart attacks that aren't classic, so that's why in my mind, I think a lot in terms of what are their risks for heart disease, and if they have a lot of risks, I'm going to do more testing on those patients.

Interviewer: And come into the E.R.

Dr. Madsen: Yeah, absolutely.

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