Mind & Body

The Big Differences Between Men's and Women's Heart Attacks

We're all familiar with that scene in movies, TV, and Redd Foxx routines. A man — it's almost always a man — suddenly stands up, knocking over the table in front of him. He clutches his chest. Grimaces horribly. His body suddenly stiffens and ... BAM. He falls flat on the ground, dead of a heart attack. But not everybody has heart attacks the same way. And how much people know about that can have a major effect on their health.

Related: Symptoms of a Heart Attack in Women

An Arrow from Your Doctor's Bow

Here's the bad news: According to a study from researchers Brad N. Greenwood, Seth Carnahan, and Laura Huang that was published in January, women are more likely than men to die from a heart attack — at least, if their emergency room doctor is a man. While most pop culture depictions of heart attacks involve a man, the risk of heart disease threatens both ends of the gender spectrum. But the way a heart attack looks and feels in a male body can be very different from how it looks and feels in a female one.

It's long been known that after suffering a heart attack, women face a much higher mortality rate — 26 percent of women die within a year of having one, while only 19 percent of men do. But the reason for this has been elusive. Greenwood, Carnahan, and Huang looked back on gender data from 500,000 heart attack cases in Florida from between 1991 and 2010 and split them into four categories: male doctors treating male patients, female doctors treating male patients, male doctors treating female patients, and female doctors treating female patients. When they did that, they saw a distinct pattern emerge.

The mortality rates were pretty steady across the board, except when male doctors treated female patients. In fact, when female patients saw male doctors instead of female doctors, their risk of death in the emergency room shot up by 12 percent. In and of itself, that's good reason to encourage diversity in the medical profession — and that's leaving aside the fact that other studies suggest that female doctors (not just heart surgeons) deliver better outcomes overall.

Know the Signs

Those are some pretty harrowing results, especially when you consider that only 23.5 percent of emergency-room doctors and 10.8 percent of cardiovascular specialists are women. That's why it's so important to know how the signs of a heart attack can look different in women.

While both men and women may suddenly feel an enormous pressure in their chest during a heart attack, women are more likely to feel some of the other common symptoms instead. Shortness of breath is more common in women than in men, as is lightheadedness, dizziness, back pressure, jaw pain, and pain in the upper abdomen. Dr. Suzanne Steinbaum, director of The Heart and Vascular Institute at Lenox Hill Hospital in New York City, says the signs could start weeks ahead of time with nausea and shortness of breath.

"If you are used to doing a certain amount of activity and then, all of a sudden, you can't get enough air, that is when I get concerned," Steinbaum told the American Heart Association. She recalled one patient who had jaw pain every time she ran on the treadmill and even saw a dentist to figure out what the trouble was. Then she had a heart attack. When Steinbaum examined her afterward, she could see that the two issues were related.

When a heart attack comes, a woman might, or might not, suddenly clutch her chest. Whatever the symptoms, it's important that women take those feelings seriously. "Many women I see take an aspirin if they think they are having a heart attack and never call 9-1-1," says Goldberg. "But if they think about taking an aspirin for their heart attack, they should also call 9-1-1." Trust your feelings — and if you can scope out a female doctor to call ahead of time, that's even better.

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If you or a loved one has suffered a heart attack, you need to be prepared for what's next. Pick up "The Cardiac Recovery Handbook" by Michelle Seaton and Paul Kligfield, MD. We handpick reading recommendations we think you may like. If you choose to make a purchase through that link, Curiosity will get a share of the sale.

Written by Reuben Westmaas October 4, 2018

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