According to the Heart Association: Every minute in the United States, someone’s wife, mother, daughter, or sister dies from heart disease, stroke, or other forms of cardiovascular disease. Although heart disease death rates among men have declined steadily over the last 25 years, rates among women have fallen significantly less. What are the differences between men and women with heart disease?

1. Women have risk factors men don’t have. Certain diseases found only in women increase the risk of Coronary Artery Disease (CAD). These include endometriosis, polycystic ovary disease (PCOS), diabetes, and high blood pressure that develops during pregnancy. Women also share traditional risk factors with men, such as high blood pressure, high blood sugar levels, high cholesterol levels, smoking, and obesity. Like men, women can be impacted by a family history of heart disease, particularly when a father or brother was diagnosed with CAD before age 55 or a mother or sister was diagnosed before age 65.
2. Women are generally older when they have their first heart attack. Men are at risk for heart attack much earlier in life than women. Estrogen offers women some protection from heart disease until after menopause when estrogen levels drop. This is why the average age for a heart attack in women is 70, but 66 in men.
3. The symptoms of heart attack can be different in women. Chest pain (also described as a crushing weight on the chest) is the most common symptom of heart attack in men. Some women also experience chest pain, but they are more likely to have different symptoms. Women often experience subtler symptoms for three or four weeks before a heart attack.
   1. New or dramatic fatigue. You aren’t exerting yourself, but you feel deeply fatigued, but can’t sleep, or have a “heavy” chest.
   2. Shortness of breath or sweating. Look out for when either symptom occurs without exertion, is accompanied by a symptom such a chest pain or fatigue, worsens over time after exertion, or sparks a cold, clammy feeling that occurs without cause. Also, if shortness of breath worsens when lying down and is relieved when you sit up. 
   3. Pain in the neck, back, or jaw. Look out for when there is no specific muscle or joint that aches or when the discomfort worsens when you are exerting yourself and stops when you stop. The pain can be in either arm; whereas, it’s usually the left arm in men. Also, pay attention to pain that starts in the chest and spreads to the back, pain that occurs suddenly and may awaken you at night, or pain in the lower left side of the jaw.
4. CAD in women is sometimes hard to diagnose. An X-ray movie (angiogram) taken during cardiac catheterization is used for finding narrowings/blockages in the heart’s large arteries. But CAD in women often affects the small arteries which cannot be clearly seen on an angiogram.
5. A heart attack is harder on a woman than a man. Women don’t tend to do as well as men after a heart attack. They often require a longer hospital stay and are more likely to die before leaving the hospital.
6. Women don’t always get the proper medications after a heart attack. After a heart attack, women are at greater risk of developing a blood clot that can cause another heart attack. It is unknown why women do not get the medications required to prevent blood clots.

No matter if you are male or female, if you experience any of these symptoms, have the ambulance take you to the emergency room!