Heart disease is often thought of as a health problem that mostly affects men. However, it’s the leading cause of death for women in the United States. According to Medline Plus, it’s responsible for about 1 in 4 female deaths each year.

Heart disease is also called cardiovascular disease.

Heart disease includes several different conditions that can affect your heart and blood vessels. These include:

  • coronary artery disease (blockages in the blood vessels around the heart)
  • peripheral artery disease (blockages in the blood vessels in the arms or legs)
  • problems with your heart’s rhythm (arrhythmia)
  • problems with your heart’s muscles or valves (valvular heart disease)
  • congestive heart failure (problem with the pumping or relaxation functions of the heart muscle)
  • coronary vasospasm (sudden contractions of an artery wall)
  • coronary microvascular disease (problems with the small blood vessels that branch off from the coronary arteries)
  • heart failure with a reduced ejection fraction (the inability of one of the heart’s chambers to contract properly)

These conditions may develop over time, or they may be a result of structural issues with the heart before birth (called congenital heart disease).

The Centers for Disease Control and Prevention (CDC) says that approximately 6 percent of U.S. women over age 20 have coronary heart disease or coronary artery disease, which is the most common type. The risk of heart disease increases with age.

We will often use “women” and “men” in this article to reflect the terms that have been historically used to gender people. But your gender identity may not align with the signs, symptoms, and risk factors of heart disease. Your doctor can better help you understand how your specific circumstances will translate into diagnosis, symptoms, and treatment.

Many women don’t have any symptoms of heart disease until they have a serious medical emergency such as a heart attack. However, if you do have early symptoms of heart disease, they may include:

These symptoms may occur either while you’re at rest or during activities of daily life. These can also be the symptoms of a heart attack.

Heart attack symptoms in women

Heart attacks are often associated with men more than women. Yet according to the Office on Women’s Health, every 100 seconds, a woman has a heart attack in the United States. After having a heart attack, women tend to wait longer before getting care, which can lead to less favorable outcomes.

A heart attack, also known as a myocardial infarction, happens when there’s a blockage in an artery that supplies blood to your heart. If there isn’t enough blood getting to your heart, it can damage the affected heart tissue and cause it to die. This places you at a high risk of heart failure and other life threatening complications.

One reason that women may not pay as much attention to a heart attack could be due to their symptoms. Women are more likely to experience nontraditional heart attack symptoms compared with men. Also, their symptoms tend to come on more gradually.

Some of the most common heart attack symptoms for women include:

  • chest pain that feels like tightness or pressure, instead of the more severe chest pain that men often feel — however, in some cases, there may be no chest pain at all
  • extreme or unusual fatigue that could develop before other symptoms and may feel like you’re coming down with the flu
  • throat and jaw pain, many times without any chest pain
  • pain or discomfort in the upper abdomen that could feel like indigestion or heartburn
  • pain, discomfort, or a tingling sensation in one or both arms
  • upper back pain that may have a burning, tingling, or pressure-like feeling
  • lightheadedness or dizziness
  • nausea and vomiting
an illustration depicting heart attack symptoms in women vs men
Illustration by Bailey Mariner

More symptoms may become apparent as heart disease progresses. Symptoms can differ depending on what specific type of heart disease you have.

The symptoms of heart disease in women are also different from those in men, who are more likely to have chest pain.

Potential later symptoms of heart disease in women include:

Some types of heart disease are congenital, which means they’re a result of issues in the way the heart was formed.

Genetic factors may also influence the chance of developing heart disease. However, there are also some conditions that can put you at a higher risk of developing heart disease. These include:

Some lifestyle factors can increase your risk of heart disease, such as:

Having heart disease also puts you at risk of a number of other conditions and issues, including:

It’s never too early to contact a doctor to discuss your risk of heart disease. In fact, the new primary prevention guidelines say that the earlier the risk factors for heart disease are prevented or treated, the less likely you are to develop heart disease later in life.

So, if you’re concerned about your risk of heart disease, make an appointment to discuss how you can prevent this highly preventable condition. You can connect with a cardiologist in your area using the Healthline FindCare tool.

If you’re having any symptoms at all, it’s very important to discuss these with your doctor, as heart disease can masquerade in many different ways.

It’s easy to dismiss many warning signs of heart disease like fatigue, indigestion, and shortness of breath as just an ordinary part of life or mild illness. But because a heart attack can happen suddenly, it’s important not to ignore any potential warning signs.

If you have any of the above symptoms of heart disease, especially if you also have risk factors, contact a doctor.

Medical emergency

Call 911 or local emergency services if you have signs of a heart attack, including:

  • chest pain, heaviness, tightness, or pressure
  • sudden and severe arm pain
  • shortness of breath
  • losing consciousness
  • heavy sweating or nausea
  • a sense of doom

To diagnose heart disease, a doctor will first ask about your personal and family medical history. They’ll then ask about your symptoms, when they started, and how severe they are. They’ll also ask about your lifestyle, such as if you smoke or exercise.

Blood tests can help a doctor figure out your risk of heart disease. The most common is a lipid profile, which measures cholesterol and triglycerides.

Depending on your symptoms and history, your doctor may do other blood tests, including tests to check:

Your doctor may order other tests, too. For example:

  • Electrocardiogram (EKG) can measure electrical activity in the heart. This helps a doctor look at issues with your heart rhythm, as well as evidence of heart attacks.
  • Echocardiogram is an ultrasound of the heart. It looks at your heart structure, function, and the performance of the heart valves.
  • A stress test can see how well your heart performs under physical stress. During this test, you’ll exercise while wearing equipment to measure your heart’s electrical signals and your blood pressure. It can predict whether you have blockages that may be limiting blood flow to your heart when you exercise.
  • Coronary calcium score uses a CT scan to show the amount of calcium in your coronary arteries.
  • Ultrasound of carotid arteries in your neck can look for stroke risk.
  • Ankle brachial index is the ratio of the blood pressure in your legs to your arms.
  • Coronary computed tomography angiography, a specialized CT scan, looks at the blood vessels around the heart to see if blockages are present.

A doctor might also suggest a continuous EKG or ambulatory arrhythmia monitor, where you wear a device that constantly records your heart’s electrical signals. Depending on your symptoms, you might wear this device for a few days or a few weeks.

If these tests are inconclusive, you may need more invasive tests to diagnose heart disease. These include:

  • cardiac catheterization, which shows if your arteries are blocked and how well your heart is working
  • implantable loop recorder, which is an arrhythmia monitor implanted under the skin that helps determine the causes of arrhythmia (irregular heart beat)

Generally speaking, heart disease treatment for women doesn’t differ much from treatment for men. The treatment will depend on the type of heart disease you have and may include:

  • Medication. Depending on the type of heart disease you have, medication may include one or more of the following:
    • Cholesterol-lowering medications can help reduce your LDL or “bad” cholesterol and increase your HDL or “good” cholesterol.
    • Angiotensin-converting enzyme (ACE) inhibitors prevent your body from forming angiotensin. Angiotensin is a hormone that can cause your blood vessels to constrict, resulting in hypertension (high blood pressure).
    • Angiotensin II receptor blockers (ARBs) also work by blocking angiotensin and can lower blood pressure.
    • Anticoagulants and antiplatelet agents help prevent blood clots from forming in your arteries.
    • Aspirin is a blood thinner that may help lower the risk of a heart attack in some people by making it harder for platelets in the blood to clot.
    • Beta-blockers include a broad category of medications that work by blocking the actions of certain chemicals that stimulate your heart.
    • Calcium channel blockers help treat high blood pressure by blocking some of the calcium that enters your heart and arteries.
    • Nitrates work by widening your blood vessels so blood can pass through more easily.

Besides medication, treatment for heart disease may include the following:

  • Cardiac stent. A cardiac stent is an expandable coil made of metal mesh that can be inserted into a narrowed coronary artery to improve blood flow to the heart.
  • Percutaneous coronary intervention. Once known as angioplasty, this is a surgical procedure that helps open the blood vessels that supply blood to the heart. A cardiac stent is often inserted after an angioplasty.
  • Coronary bypass surgery. In more severe cases, coronary bypass surgery may be recommended. This involves open heart surgery. A surgeon will remove a healthy blood vessel from your leg and use it to bypass a blocked or damaged artery in your heart. According to a 2018 study, women tend to have coronary bypass surgery less often than men.

The risk factors for heart disease are complicated and include genetics, other biological factors, and general health and lifestyle factors.

While you may not be able to completely eliminate your risk of heart disease, you can take steps to reduce it. These include:

  • Get your blood pressure checked regularly. If it’s high, work with your doctor to lower it. This may include medication and lifestyle changes.
  • If you smoke, seek help to quit. This can be difficult, but a doctor can help create a smoking cessation plan that’s right for you.
  • If you have risk factors for diabetes, such as family history or obesity, get your blood sugar tested.
  • If you do have diabetes, keep blood sugar under control.
  • Maintain a weight that works for your body.
  • Eat a healthy diet that’s high in whole grains, fruits and vegetables, and lean meats.
  • Limit your alcohol intake to no more than one drink per day.
  • Manage stress levels.
  • Get your cholesterol checked and take steps to lower high cholesterol if you need to.
  • If you have sleep apnea, or believe you do, seek treatment.
  • Exercise regularly.
  • If you’ve had a heart attack, talk with your doctor about daily low dose aspirin. This isn’t recommended for women who haven’t had a heart attack or stroke, as it can increase bleeding.

Heart disease is much more common in women than many people realize. In fact, it’s the leading cause of death for women.

Many women who have heart disease don’t have any symptoms. Connect with your doctor early to determine your risk of heart disease and how you can reduce this risk.

If you do have symptoms, it’s important to contact a doctor as soon as possible so they can test for heart disease and provide treatment before heart damage occurs.

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