Did you know that heart diseases kill twice as many women worldwide compared to the statistics of all cancers in women combined – making it the gender’s number one killer?
Yet the majority of women questioned on the topic believe that it is one form of cancer that is the top culprit. This interview aims to understand better the specific heart health concerns women face.
Q: Are there heart problems or diseases that are specific to women?
Dr A: Across the board for both genders, the four common heart problems are coronary heart disease (the narrowing of a blood vessel); arrhythmia (abnormal heart rhythm); valvular heart disease (the thickening of heart valves); and hypertensive heart disease (brought about by high blood pressure, resulting in the thickening of the heart muscle).
A peculiar thing to note is that women can undergo pregnancy-induced heart conditions. Some cases may be temporary and can be treated with medication, but others may have to live with such problems for their lifetime. A pregnancy could suddenly prompt the heart to behave differently and can even lead to heart failure.
Q: How do the statistics of heart diseases in women stack up against men?
Dr A: In 2009, it was officially reported that heart disease is the number one cause of death amongst women. This information shocked many as when heart diseases were initially investigated, most patients in the trials were men – leading to skewed results. But when they finally included real world data – both men and women – they found that 2.4 million women die worldwide annually from heart diseases compared to 2.1 million men.
Locally, the Ministry of Health of Malaysia also found that 24 percent of female deaths in Malaysian hospitals between 2009 to 2014 were due to heart diseases compared to 10 per cent of all cancers combined.
Q: What are some symptoms of heart diseases women should look out for?
Dr A: One of the reasons why more women succumb to fatal heart diseases than men is because the symptoms they experience and present are atypical. This means that instead of chest pains, which often plague men with heart problems – women suffer from flu-like symptoms. While they can get chest pains, more often than not, women will experience light-headedness, shoulder and back pain, and lethargy – usually leading to a misdiagnosis.
They can also get pain in the jaw – especially when exerting themselves going up the stairs. This is because the jaw and heart share the same nerve roots. Hence, by the time they receive a proper diagnosis, it can be too late.
For example, in one recent case, a 52-year old woman had been to her general practitioner (GP) with stomach pains which she had for two days in a row. She was diagnosed with gastritis but none of the medication worked. ECGs were done, but everything appeared to be normal. On the third day, she decided to go the hospital and a quick scan (echocardiogram) by her bedside revealed that she was going through a full-blown heart attack.
The reason for the misdiagnosis was because the bottom bit of the heart sits above the stomach – so the pain was perceived as coming from the stomach.
She underwent angioplasty (stenting) immediately, but significant damage had already been done. With heart attacks, time is of the essence – any part of the heart that doesn’t receive blood supply for just three minutes will see its blood cells get strangulated as they start to swell up and burst. So, if possible, the blocked artery should be opened up in the first hour or two after the symptoms have started. Unlike other cells, muscles involving the heart and brain do not regenerate once dead.
Q: Could you share a few tips to help prevent such heart problems?
Dr A: An important thing to note about women is that the risk of heart disease increases past the age of 40, but escalates once they reach the perimenopause stage (the period before menopause). This is because their estrogen levels will fall, which in turn, increases blood pressure and cholesterol levels – heightening the risks of heart attacks and strokes. Therefore, once women enter perimenopause, they should get their blood and pressure checked every three to four months.
Another interesting bit of information is that women who are diagnosed with pregnancy-induced hypertension will often develop true hypertension and coronary heart disease later on in life – so these women have to be more vigilant with their check-ups. Other than that, these are some lifestyle changes one can make:
- Keep an eye on your cholesterol levels.
- Steer clear of smoking.
- Moderate amounts of alcohol can be harmful, so this is best avoided as well.
- Pencil time in to exercise regularly – at least 30 minutes a day. Several days a week is ideal, but any exercise is better than none.
Dr Norazlina bt Mohd Yusof
Consultant Cardiologist, Prince Court Medical Centre
