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Heart Attack Signs in Women

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest
Pain or discomfort in one or both arms, the back, neck, jaw or stomach

Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath with or without chest discomfort.

Shortness of breath with or without chest discomfort.
Breaking out in a cold sweat, nausea or lightheadedness.

Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somehow more likely than men to experience these common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Even though heart disease is the No. 1 killer of women, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or normal aging. Heart disease is the world’s biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years.

Heart disease in Women

Angina in Women Can Be Different Than Men

Angina (chest pain)

Angina (chest pain) is a warning sign of heart disease, and recognizing it and getting treated early may prevent a heart attack. Fatty build-up in your coronary arteries, called plaque, prevents blood flow that’s needed to provide oxygen to your heart muscle.

Women more frequently develop heart disease within the very small arteries that branch out from the coronary arteries – microvascular disease (MVD) and occurs particularly in younger women.

Heart disease in men

On the other hand, Heart disease in men usually is due to blockages in their coronary arteries – obstructive coronary artery disease (CAD). Up to 50 percent of women with anginal symptoms who undergo cardiac catheterization don’t have the obstructive type of CAD.

You may have tightness, pressure or discomfort in your chest during physical activity or when stressed. But it goes away shortly after you stop the activity or get rid of the stress.

You may have tightness, pressure or discomfort in your chest during physical activity or when stressed
feeling out of breath, nausea, vomiting, abdominal pain or sharp chest pain

Angina symptoms in women can also include feeling out of breath, nausea, vomiting, abdominal pain or sharp chest pain.  Once the extra demand for blood and oxygen stops, so do the symptoms.



In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:

Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is bypass surgery. Although surgery is more risky for people with heart failure, new strategies before, during, and after surgery have reduced the risks and improved outcomes.

Heart valve surgery

Diseased heart valves can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuloplasty).

Implantable left ventricular assist device (LVAD). The LVAD is known as the “bridge to transplantation” for patients who haven’t responded to other treatments and are hospitalized with severe systolic heart failure. This device helps your heart pump blood throughout your body. It allows you to be mobile, sometimes returning home to await a heart transplant. It may also be used as destination therapy for long-term support in patients who are not eligible for transplant.

Heart valve surgery

Heart transplant

A heart transplant is considered when heart failure is so severe that it does not respond to all other therapies, but the person’s health is otherwise good.

Heart transplant


The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.

Stages of Heart Failure

Stage A

Definition of Stage

People at high risk of developing heart failure (pre-heart failure), including people with:

  • High blood pressure
  • Diabetes
  • Coronary artery disease
  • Metabolic syndrome
  • History of cardiotoxic drug therapy
  • History of alcohol abuse
  • History of rheumatic fever
  • Family history of cardiomyopathy
Usual Treatments
  • Exercise regularly.
  • Quit smoking.
  • Treat high blood pressure.
  • Treat lipid disorders.
  • Discontinue alcohol or illegal drug use.
  • An angiotensin converting enzyme inhibitor (ACE inhibitor) or an angiotensin II receptor blocker (ARB) is prescribed if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
  • Beta blockers may be prescribed if you have high blood pressure or if you’ve had a previous heart attack.
Usual Treatments for Stage A
Usual Treatments for Stage A

Stage B

Definition of Stage

People diagnosed with systolic left ventricular dysfunction but who have never had symptoms of heart failure (pre-heart failure), including people with:

  • Prior heart attack
  • Valve disease
  • Cardiomyopathy
  • The diagnosis is usually made when an ejection fraction of less than 40% is found during an echocardiogram test.
Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) or angiotensin II receptor blocker (ARB)
  • Beta-blockers should be prescribed for patients after a heart attack
  • Surgery options for coronary artery repair and valve repair or replacement (as appropriate) should be discussed
  • If appropriate, surgery options should be discussed for patients who have had a heart attack.
Usual Treatments for Stage B

Stage C

Definition of Stage

Patients with known systolic heart failure and current or prior symptoms. Most common symptoms include:

  • Shortness of breath
  • Fatigue
  • Reduced ability to exercise
Reduced ability to exercise

Reduced ability to exercise

Shortness of breath

Shortness of breath

Fatigue

Fatigue

Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) and beta-blockers
  • African-American patients may be prescribed a hydralazine/nitrate combination if symptoms persist
  • Diuretics (water pills) and digoxin may be prescribed if symptoms persist
  • An aldosterone inhibitor may be prescribed when symptoms remain severe with other therapies
  • Restrict dietary sodium (salt)
  • Monitor weight
  • Restrict fluids (as appropriate)
  • Drugs that worsen the condition should be discontinued
  • As appropriate, cardiac resynchronization therapy (biventricular pacemaker) may be recommended
  • An implantable cardiac defibrillator (ICD) may be recommended

Stage D

Definition of Stage

Patients with systolic heart failure and presence of advanced symptoms after receiving optimum medical care.

Usual Treatments

Treatment methods for Stages A, B & C apply
Patient should be evaluated to determine if the following treatments are available options: heart transplant, ventricular assist devices, surgery options, research therapies, continuous infusion of intravenous inotropic drugs and end-of-life (palliative or hospice) care.

Usual Treatments of Stage D


Your doctor will ask you many questions about your symptoms and medical history. You will be asked about any conditions you have that may cause heart failure (such as coronary artery disease, angina, diabetes, heart valve disease, and high blood pressure). You will be asked if you smoke, take drugs, drink alcohol (and how much you drink), and about what drugs you take.

How Is Heart Failure Diagnosed?

You will also get a complete physical exam

Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

Blood tests

Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia. Anemia is a blood condition that occurs when there is not enough hemoglobin (the substance in red blood cells that enables the blood to transport oxygen through the body) in a person’s blood.

B-type Natriuretic Peptide (BNP) blood test

BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen, and decrease when the heart failure condition is stable. The BNP level in a person with heart failure — even someone whose condition is stable — is higher than in a person with normal heart function. BNP levels do not necessarily correlate with the severity of heart failure.

Chest X-ray

A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

Echocardiogram

This test is an ultrasound which shows the heart’s movement, structure, and function.

The Ejection Fraction (EF) is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present. Your doctor can discuss which condition is present in your heart.

Echocardiogram

Electrocardiogram (EKG or ECG)

An EKG records the electrical impulses traveling through the heart.

Cardiac catheterization

This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.

Stress Test

Stress Test

Noninvasive stress tests provide information about the likelihood of coronary artery disease.

Other tests may be ordered, depending on your condition.



Heart failure is caused by many conditions that damage the heart muscle, including:

Coronary artery disease. Coronary artery disease (CAD), a disease of the arteries that supply blood and oxygen to the heart, causes decreased blood flow to the heart muscle. If the arteries become blocked or severely narrowed, the heart becomes starved for oxygen and nutrients.

Narrowing of Artery
Narrowing of Artery
Normal Artery
Normal Artery

Heart Attack

heart attack occurs when a coronary artery becomes suddenly blocked, stopping the flow of blood to the heart muscle. A heart attack damages the heart muscle, resulting in a scarred area that does not function properly.

Narrowing of Artery
Cardiomyopathy

Cardiomyopathy

Damage to the heart muscle from causes other than artery or blood flow problems, such as from infections or alcohol or drug abuse.

Conditions that overwork the heart. Conditions including high blood pressurevalve diseasethyroid disease, kidney diseasediabetes, or heart defects present at birth can all cause heart failure. In addition, heart failure can occur when several diseases or conditions are present at once.

Cardiomyopathy


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Emirates Cardiac Society (ECS) is a non-profit organization comprising of cardiologists within the UAE that work under the umbrella of the Emirates Medical Association.


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