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Heart Attacks: Differences in Women and Men

While the rhythm of our hearts share a unifying beat, the dangers it faces aren’t always the same. Cardiovascular disease affects men and women differently. Dispelling a widespread misconception, cardiovascular disease (CVD) isn’t solely a “men’s disease.” It’s impacts both sexes and happens to be the primary cause of death among women.

The landscape of cardiovascular disease varies for men and women. Typically, men encounter CVD, especially coronary heart disease, earlier in life, leading to higher middle-age mortality rates. However, women aren’t spared – their CVD risk escalates post-menopause, aligning them with men’s risk levels.

Data further highlights these gender differences: women generally endure their first heart attack around the age of 72, about ten years later than men’s average age of 61. This crucial decade gap emphasizes how gender and age affect cardiovascular disease occurrence.

Despite the reprieve granted by later onset, women navigate treacherous waters. They are 20% more likely to develop heart failure or, tragically, lose their lives within five years after a severe heart attack, a risk outpacing their male counterparts.

The signs of an impending heart attack, the experience during an actual attack, and even the traditional treatment and recovery aren’t a one-size-fits-all deal. They often vary significantly between men and women.

Symptoms Leading Up to a Heart Attack

The narrative presented by mainstream media and conventional medicine often paints heart attacks as sudden, unforeseeable events. This picture, however, doesn’t fully capture the nature of these potentially lethal incidents. In reality, heart attacks are rarely stealthy predators. Instead, the body often sends warning signals ahead of these catastrophic events.

Angina – a medical term that’s become synonymous with heart-related discomfort – often rears its head under stress or vigorous physical activity. It’s essentially the heart muscle’s cry for oxygen, as it wrestles with the intensified workload. Angina is often one of the first signs of coronary artery disease (CAD).

Despite the stereotype of angina being predominantly a man’s plight, research paints a slightly different portrait. It shows angina to be a more frequent unwelcome guest in women’s lives. Women, however, tend to confound medical conventions with their often atypical, stray-from-the-norm symptoms.

The customary image of chest-clutching, air-gasping distress associated with heart disease often doesn’t apply to women. Delving into a recent study, women articulated their angina more as discomfort radiating to the back, abdomen, neck, and chin. Men, on the other hand, remained loyal to the traditional picture of chest pain. Strikingly, most men linked their discomfort to heart disease, whereas a substantial 73% of the women participants didn’t make the same connection.

Further investigations bring to light more gender-based differences in heart disease manifestation. A surprising number of women combat extra indigestion, queasiness, and gastric grievances related to their heart disease, compared to their male counterparts. These symptoms, unfortunately, often get brushed under the rug, dismissed as non-heart-related issues.

We can’t have a heart-to-heart about cardiovascular disease without addressing fatigue, a significant yet often underestimated symptom. In men, fatigue typically echoes the heart’s strain from physical exertion. Yet, in women, the story takes an unpredictable turn. The fatigue woven into their heart disease narrative often materializes without any apparent ties to physical activity, making it even more elusive to identify.

Described often as a ‘heavy’ or ‘unrelenting’ exhaustion, this fatigue can creep in weeks, even months, before a heart attack strikes. Alarmingly, it may be the only symptom in some women. This pivotal symptom, despite its immense importance, is habitually swept under the rug. Women may misinterpret it as garden-variety exhaustion, or chalk it up to the relentless whirl of daily life. A 2020 study uncovers a disconcerting fact – fewer than 7 percent of women were cognizant of fatigue as a potential harbinger of heart disease.

These subtle, yet profound disparities in pre-heart attack signs underscore the pressing need for a gender-sensitive lens in our comprehension, detection, and management of CAD and other cardiac ailments. It’s high time we acknowledge that, in matters of the heart, one size does not fit all.

Heart Attack Symptoms in Men vs. Women

Quick recognition and timely intervention can be life-saving when dealing with an acute myocardial infarction (MI), the medical term for a heart attack. Even though symptomatology can fluctuate, chest pain holds its ground as the most frequent sign of a heart attack for both genders. One particular study reports chest pain in a staggering 89.5 percent of men and 87 percent of women amid a heart attack.

Heart attacks in women can be surprising, often skipping the textbook symptom of chest pain. According to one study, women tend to experience additional, less typical symptoms compared to men. These might include heart palpitations, stomach upset, or aches in the jaw, neck, arm, or between the shoulder blades. Interestingly, 62% of women reported such symptoms during their heart attack, as opposed to 55% of men.

What’s more, the research reveals a concerning trend. In severe heart attacks known as ST-segment-elevation myocardial infarctions, women were less likely to experience the standard chest pain.

Women are often more prone to attributing these symptoms to stress or anxiety, while men might blame muscle strain. It’s also worth noting that before their hospital admission, roughly 29.5% of women and 22.1% of men sought medical help for similar symptoms.

Remember, the constellation of symptoms during a heart attack can paint a complex, varied picture for both genders. Do not second-guess seeking medical attention if you suspect a heart attack.

Most common heart attack symptoms in women

  • Chest pain or pressure, but not always
  • Dizziness
  • Discomfort between shoulder blades
  • Jaw, arm, or neck discomfort
  • Shortness of breath
  • Indigestion or gas-like pain
  • Pressure in the lower chest or abdomen
  • Nausea or vomiting
  • Extreme fatigue
  • Increased anxiety
  • Rapid or irregular heartbeat

Most common heart attack symptoms in men

  • Chest pain
  • Pressure or discomfort in the left arm, neck, or jaw
  • Shortness of breath
  • Heartburn or indigestion
  • Sweating
  • Nausea
  • Rapid or irregular heartbeat

Heart Attack Treatments in Men vs. Women

When it comes to heart attacks, differences between women and men extend beyond symptom presentation. They can also be seen in the treatment strategies, starting as early as the ambulance ride.

A study by George Washington University has shed light on glaring inequities in emergency medical services (EMS) responding to 911 calls for potential heart attacks. The research unveiled a disconcerting pattern: women were less likely to be offered aspirin, resuscitated, or ferried to the hospital with the urgency of lights and sirens compared to their male counterparts.

This discrepancy in gender-based treatment for heart disease extends beyond the EMS response and into the labyrinth of clinical diagnosis. Evidence unveils a trend toward women’s heart attacks being misdiagnosed more frequently than men’s. In a sweeping study of over 41,000 patients, women were less likely to receive a heart attack diagnosis than men. This gender chasm became evident not only among patients who presented late but also in the physicians’ evaluations. This contributes to a heightened risk of a missed or delayed diagnosis in women.

Another investigation, examining more than half a million heart attack patients across England and Wales, found that the scales of misdiagnosis tipped notably against women. Specifically, women had a 59% and 41% higher likelihood of having total and partial artery blockage heart attacks, respectively, misdiagnosed compared to men.

But why is this? For one, during a heart attack, the protein troponin is released into the bloodstream aiding in diagnosis. However, women may exhibit lower troponin levels even during a heart attack, making it easy to misdiagnose.

Even with improved testing, however, it’s hard to say if treatment would change. A clinical trial led by the University of Edinburgh utilized high-sensitivity troponin blood tests with gender-specific thresholds, increasing the number of women correctly identified with heart attacks by 42%. However, even with an improved diagnosis, women were half as likely as men to receive vital heart attack treatments like stent fitting and dual antiplatelet therapy. Despite the diagnostic advancements, there was no reduction in the rate of women experiencing subsequent heart attacks or dying from cardiovascular disease within a year.

Heart Attack Recovery in Men vs. Women

Navigating the turbulent waters post heart attack is a distinct journey for men and women. Scrutiny of available data reveals a worrying trend – within half a decade of a maiden heart attack, 47% of female patients find themselves grappling with mortality, heart failure, or a stroke. A contrastingly lower 36% of men share the same fate.

A 2023 study out of Yale found that younger women fare worse in the year following a heart attack than men. After a heart attack, women are frequently burdened with more physical and psychological hurdles. Take physical discomfort, for instance. Women report more severe chest pain, fatigue, and dyspnea – that dreaded sensation of gasping for breath – following their cardiac event.

What’s more, older women often encounter greater mobility constraints and an elongated journey to recuperation, primarily influenced by their more advanced age at the onset of a heart attack, coupled with an increased prevalence of simultaneous chronic diseases like diabetes or hypertension.

Mental health is another critical aspect of recovery where gender differences emerge. Women are more susceptible to depression and anxiety in the aftermath of a heart attack. Research has shown that this increased psychological distress impacts their quality of life and leads to higher hospital readmission rates.

Similarly, we mustn’t overlook the vital role social support or the lack thereof, plays in shaping the recovery trajectory. Women, particularly the more seasoned in age, tend to lead more solitary lives compared to men, depriving them of the informal care network of family and friends that can be so instrumental in recovery.

Lastly, an alarming disparity exists in women’s involvement in cardiac rehabilitation programs, despite their significance in propelling recovery and forestalling future cardiac events. Women lag behind men in this regard, a gap that can be attributed to a myriad of reasons. These can range from practical impediments like lack of transportation or limited time, lower physician referral rates, or a void in gender-specific considerations in these programs’ blueprint.

Next Steps

While conventional treatment of heart attacks may indeed vary by gender, the approach we take at Natural Heart Doctor remains unwaveringly individualized. We understand that each person is unique, but we firmly believe that the key to treating heart disease lies in addressing its root cause, regardless of one’s sex.

This is where our mantra of Eat Well, Live Well, Think Well comes into play, encapsulating our holistic approach to heart health. Our ultimate goal is to empower you to attain your 100 year heart.

We acknowledge the disparities in heart disease and its treatment between men and women, but at Natural Heart Doctor, these differences do not determine our treatment plan. Instead, we focus on treating the underlying cause of heart disease, tailoring our approach to each individual’s needs.

As a part of this commitment, we offer a free 20-minute health consultation with one of our experienced health coaches to help guide you on this journey. We strive to work hand in hand with you, providing personalized care and guidance every step of the way.

In order to live well, one must eat well.

Get the Natural Heart Doctor approved Diet and discover how to eat for your 100 Year Heart.

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Discover how we can help you achieve your 100 Year Heart.

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.

Chiropractic

Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

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Acupuncture

Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

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Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

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Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

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Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

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Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email health@naturalheartdoctor.com. A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.