Heart to Heart

From symptoms to survival, heart disease strikes men and women differently.

Heart disease is the top killer of U.S. women, claiming a half million lives each year. From symptoms to stents, there are variations in heart disease between men and women.

Likelihoods diverge. Thanks to the protection of hormones, women don't generally experience heart attacks until their 60s, about 10 years later than men. But hormone replacement therapy doesn't offer the same benefit, warns Mary Youssef, M.D., a cardiologist on the medical staff at Memorial Hospital.

For women who smoke, have diabetes or have had their ovaries removed, the age gap closes. And once people get into their 70s, women and men are equally likely to have heart disease.

Pain or fatigue? Typically people having a heart attack describe chest pain radiating to the arm or neck, sweating, nausea and trouble breathing. "But sometimes women don't present with chest pain and shortness of breath," Dr. Youssef says. "They may feel tired or sweaty, or just not feel themselves."

Speed is key. No matter what the symptoms, it's important for anyone with a heart attack to be diagnosed quickly, since fast treatment is key to protecting crucial heart muscle.

Beyond the attack. Because women sometimes ignore symptoms, their heart disease can be more advanced by the time they seek treatment. They also tend to be older, and thus are more likely to have complications. Surgical procedures are also more challenging because their blood vessels are smaller. But once women get past the challenges of surgery they typically recover as well as men do.

By Stephanie Thurrott