Heart Health: We Are NOT Little Men

Heart Disease: Not Just a Man’s Disease

Heart disease remains the leading cause of death for women—more than all cancers combined. Despite this, it is often thought of as a "man’s disease," leading to misdiagnosis and under-treatment in women.

Traditional testing and diagnosis strategies were designed with men in mind. Men typically develop blockages in one area of an artery, making their heart disease easier to detect. However, women often experience diffuse disease throughout the arteries or within the microvasculature, which is harder to identify with standard tests. As a result, many women are misdiagnosed, with their symptoms often attributed to gastrointestinal issues or anxiety.

The Gender Bias in Diagnosis & Treatment

Research has shown clear gender disparities in heart disease treatment:

• Women with symptoms of heart disease are less likely to receive exercise ECG tests or coronary angiograms.

• Women diagnosed with heart disease are less likely to be prescribed antiplatelet therapy, statins, or preventive medications.

• Women with confirmed coronary disease are twice as likely to suffer death or a nonfatal heart attack within a year compared to men.

Recognizing Symptoms: The Female Perspective

Many people associate heart attacks with the "elephant on the chest" sensation that men typically experience. However, women’s symptoms are often different and more subtle, making them easier to dismiss.

Common Symptoms in Women:

✔️ Chest pain (most common)
✔️ Shortness of breath
✔️ Jaw, back, or neck pain
✔️ Dizziness or nausea
✔️ Flu-like symptoms
✔️ Sleep disturbances

💡 A Sign to Take Seriously: If everyday activities—like climbing stairs or carrying groceries—suddenly feel harder, ask yourself: Is it my heart? Don’t ignore the signs.

Medical Gaslighting & Advocacy

Women often face medical gaslighting when it comes to cardiovascular symptoms. Doctors may downplay, misinterpret, or dismiss symptoms, leading to dangerous delays in treatment.

💪 Trust yourself. You know your body better than anyone else. If something feels wrong, advocate for yourself. If you struggle to do so, bring a friend, partner, or family member to help you demand the care you deserve.

Meet Natalie, founder of PAUZ Health, while at an Ironman race she was having troubles breathing. The medics at the race found her blood oxygen levels to be at 80 and her blood pressure extreme. When she returned home she went to the hospital, they ran some tests but could not find anything so they sent her home with a referral to an outpatient cardiac clinic. That night, she could not breath, scared she was going to die in the night, her husband drove her to a hospital where she knew some staff. They kept her in the emergency department for several days running tests and unable to find anything. Finally, she was admitted to the cardiac unit. There she remained with more tests and was blessed to be seen by a cardiac specialist with expertise in endurance exercise. They diagnosed her with high blood pressure due to family genetics and Swimming Induced Pulmonary Edema. Without advocating and pushing, she is not sure where she would be today. Moreover, she is passionate about learning your health risks, if she knew her father had high blood pressure at a young age, it may have informed her journey. If she also monitored her baseline health more proactively, she may have been aware of the high blood pressure earlier.

Do you see yourself in Natalie?

Why Awareness is Declining

The 2019 National AHA Survey on Women’s Cardiovascular Disease Awareness revealed that despite ongoing awareness campaigns, knowledge of heart disease as the leading cause of death among women decreased by 21% from 2009 to 2019.

Additionally, only 13% of women recognize heart disease as a personal health risk. Many still believe breast cancer is their primary health threat, despite the fact that heart disease kills far more women each year.

Resources

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Bird CE, Fremont AM, Bierman AS, Wickstrom S, Shah M, Rector T, Horstman T, Escarce JJ. Does quality of care for cardiovascular disease and diabetes differ by gender for enrollees in managed care plans? Womens Health Issues. 2007;17:131–138. doi: 10.1016/j.whi.2007.03.001.

Chou AF, Scholle SH, Weisman CS, Bierman AS, Correa-de-Araujo R, Mosca L. Gender disparities in the quality of cardiovascular disease care in private managed care plans. Womens Health Issues. 2007;17:120–130. doi: 10.1016/j.whi.2007.03.002.

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Mcmahan, C., Gidding, S., Malcom, G., Schreiner, P., Strong, J., Tracy, R., Williams, O., & Mcgill, H. (2007). Comparison of coronary heart disease risk factors in autopsied young adults from the PDAY Study with living young adults from the CARDIA study.. Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology, 16 3, 151-8 . https://doi.org/10.1016/J.CARPATH.2006.12.003.

Mueck, A., Seeger, H., & Wallwiener, D. (2004). Estrogen/Statin-Kombination: Wirkung auf Marker für die Plaquestabilität. Geburtshilfe Und Frauenheilkunde, 64, 59-62. https://doi.org/10.1055/S-2003-44699.

Stevenson, J. (2002). Hormone therapy and heart disease. The Lancet, 359. https://doi.org/10.1016/S0140-6736(02)07849-2.

Suaya JA, Shepard DS, Normand SL, Ades PA, Prottas J, Stason WB. Use of cardiac rehabilitation by Medicare beneficiaries after myocardial infarction or coronary bypass surgery. Circulation. 2007;116:1653–1662. doi: 10.1161/CIRCULATIONAHA.107.701466.

Vaideeswar, P., Tyagi, S., & Singaravel, S. (2019). Pathology of atherosclerotic coronary artery disease in the young Indian population. Forensic Sciences Research, 4, 241 - 246. https://doi.org/10.1080/20961790.2019.1592315.

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https://www.heart.org/en/news/2023/02/20/the-connection-between-menopause-and-cardiovascular-disease-risks