The difference between men and women? It can be all in the heart

How might heart attacks differ in women and men?

“The majority of time, they present pretty similarly, with the standard cardiac symptoms of crushing chest pain, shortness of breath, sweating, radiation (of pain) to the jaw and neck, those types of things,” says Dr. Derek Meeks, an assistant professor and vice chairman of the primary care department at Touro University of Nevada College of Osteopathic Medicine and chief of staff and director of the emergency department at Boulder City Hospital.

However, women are generally about 10 years older than men when they first present, he notes.

“Men just develop coronary artery disease earlier, on average about 10 years earlier than women,” he says.

Also, he says, women may have subtler symptoms, and they will have a delay in diagnosis for that reason.

“Many times they’re perceived as having more stress and anxiety,” he says, “and, therefore, (receive that) diagnosis of the symptoms that are really cardiac symptoms.”

“Sometimes (women) just feel fatigued, or maybe break out in a sweat. Sometimes they might even have abdominal pain. That could be in everyone, but it seems that some women have more of a tendency to have those nonspecific symptoms than men.”

The American Heart Association advises women to seek immediate medical help if they feel uncomfortable pressure, squeezing, fullness or pain in the center of the chest; pain or discomfort in one or both arms, the back, neck, jaw or stomach; shortness of breath with or without chest discomfort; or if they break out in a cold sweat or experience nausea or lightheadedness.

Laymen probably do know the obvious symptoms, Meeks says, “but we’re probably not as familiar with appreciating the more subtle symptoms.

“What they see on TV is people falling to the ground, which is not that common,” he says. “So they assume that if they don’t have those pains, they’re OK. But they could have a more subtle pain, where they feel more fatigued and short of breath and more out of breath, and you’re sweating, and maybe you have arm pain or jaw pain, but not really much chest pain at all.”

But, heart disease is the nation’s No. 1 killer of people of either sex. And although it generally occurs in middle-aged and older people, it can occur in younger people, too.

“Genetics are involved, health problems are involved, and sometimes drug use,” Meeks says. “Those kind of things can cause younger people to have a heart problem.

“So, again, if you have symptoms, you’ve got to get it checked out.”