The Truth About Women’s Heart Health

Clarifying the myths and facts about women’s heart health.

A new survey says that 56 percent of women now say they are aware that heart disease is their Number One killer.

A new survey says that 56 percent of women now say they are aware that heart disease is their Number One killer.

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Unlike telling people to ditch the cheesecake or prime rib, exercise is "one behavior that actually makes you feel better," Hayes says. She also advises getting seven to eight hours of sleep each night.

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MYTH: My chest pain was on the right side, not the left, so I couldn't be having a heart attack.

"That's a total myth," Goldberg says. The pressure or tightness associated with heart disease can show up anywhere in the chest, even the upper abdomen, and commonly spreads to the arm, neck, and jaw, she says. But unlike men, for whom chest pain is the most common symptom of heart attack, only half of female heart attack patients report chest pain, Cook says. Women more often have back or neck pain, indigestion, heartburn, nausea, extreme fatigue, or trouble breathing, she says. Women are also prone to specific, less-understood conditions such as coronary microvascular disease, which affects the walls of the heart's arteries, and "broken heart syndrome," in which severe emotional stress causes heart muscle failure.

Also, women are more likely to delay reporting heart attack symptoms and less likely to receive the same quality of care shown to men, Cook says, citing lower rates of treatment and more bleeding complications among female cardiac patients.

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Similar challenges affect women suffering from stroke. According to a recent Mayo Clinic survey of 209 stroke patients, only 27 percent of the females could name more than two of the six basic symptoms for stroke. The study also showed that married men called an ambulance within 28 minutes of experiencing symptoms, while married women waited 67 minutes, on average. (The disparity among singles was negligible).

Here, too, women experience unique symptoms that may affect their diagnosis, says Eva Rzucidlo, associate professor of vascular surgery at Dartmouth University's Geisel School of Medicine. Classic stroke symptoms include numbness or weakness in the face or arm, a loss of speech or hearing, dizziness, and headache. But women's symptoms can include trouble breathing or even the hiccups, Rzucidlo says. At stake is the extent of recovery, since stroke patients only have a few hours for powerful clot-destroying medicine to take effect.

[See 7 Steps Toward a Healthy Heart (and Long Life).]

"We have to be our own advocates, especially if you have risk factors," Rzucidlo says. "The most important thing is for you to understand your disease ... It means talking to your doctor and understanding what your risk factors are and how you can modify those risk factors to make yourself as healthy as possible."

Corrected on 2/19/2013: A previous version of this story misstated Nieca Goldberg's title. She is the medical director of The Joan H. Tisch Center for Women's Health at NYU's Langone Medical Center.