Her heart is more at risk
Dr Amar Singhal

Any pain or discomfort in the jaw, neck, back, arms, in between the shoulder blades or pressure and tightness in your chest can indicate a heart attack. Thinkstock

When you think of someone having a heart attack or myocardial infarction (MI), the most common image that comes to mind is of a person clutching his chest. While chest pain or angina is the most common symptom of a heart attack, it may not be the most common one in young women.

While most women may experience mild or subtler symptoms than the crushing pain usually associated with heart attacks likened to an elephant sitting on the chest, the severity of the attack isn’t any less. Instead of chest pain, women may feel a light pressure in their chest due to blockage in the smaller arteries that supply blood to the heart commonly called small vessel heart disease or micro-vascular disease. Researchers speculate that the difference in symptoms that men and women show while having a heart attack is difficult to comprehend and might be because of anatomical differences such as the difference in nerves connecting to the heart and higher pain threshold in women. As women experience milder symptoms, they downplay it and end up going to the hospital much later after significant heart damage has occurred.

So what are the symptoms that young women experience and should not overlook as a minor discomfort? Young women can experience a number of symptoms that are unrelated to pain, such as:

Upper body discomfort or pain: Other than the obvious chest pains, any pain or discomfort in the jaw, neck, back, arms, in between the shoulder blades or pressure and tightness in your chest can indicate a heart attack.

Trouble in breathing: If climbing a flight of stairs or doing simple daily tasks takes the breath out of you, you might be in trouble. Unexplained shortness of breath or coughing are early signs of heart attack in women. The pumping function of the heart decreases, increasing blood pressure in your lungs and heart resulting in breathing difficulties.

Disturbed sleep patterns: Prolonged disturbances in sleep patterns or sleep apnea causing the partial or complete blockage of the upper airway interrupting breathing can be signs of a heart attack. If you wake up from sleep and are not able to catch your breath, you might be having a heart attack.

Dizziness and sweating: Having a heart attack might make you feel dizzy and light-headed or give you clammy perspiration. While these are also symptoms of menopause, they can be a stroke warning too. Call a doctor.

Fatigue: Most women will attribute fatigue to normal reasons such as less sleep, over-exerting themselves or a side effect of some medication, but unusual fatigue can be an early symptom of a heart attack. This fatigue can be caused by decreased blood flow to the brain. When your heart doesn’t pump oxygen and glycogen rich blood, your body is deprived of energy needed to fuel your organs.

Nausea, vomiting or indigestion: Women are twice as likely as men to experience gastrointestinal problems during a heart attack. Women may feel nauseous or vomit right before a heart attack. It is an early symptom. Acid reflux causes a sharp pain right behind the heart, leading women to think of it as heartburn and ignore their symptoms thinking it will pass.

Panic attacks: Many women attribute the symptoms of a heart attack to a panic attack. A heart attack does mimic a panic attack. Rapid, irregular heartbeats and sweating cannot be taken lightly; it might be a heart attack. Especially if you feel this while participating in a calming activity such as meditation. Call for help immediately.

The risks of heart diseases are the same in women as in men. Changing lifestyles has led to an increasing number of young women going into menopause early. For women who go into early menopause, the risk of coronary heart disease and stroke increases two-fold. Oestrogen keeps the blood vessels flexible, allowing them to easily expand and contract to allow blood flow. During menopause though, oestrogen levels go down, increasing risk. Fats in the bloods increase along with increased plaque deposition on the vessel walls.

Most young women trust their oestrogen levels to protect their heart, but they also need to be aware about the risk factors and symptoms of heart attack. Anyone can get a heart attack; even if you are a healthy young woman you can still have a heart attack. If you experience any one of the above mentioned symptoms then consult a doctor. Waiting for the symptoms to pass, putting family or work first and ignoring your health, can only cause more damage to your heart. Start listening to your heart.

The writer is head of department, Cardiology, Sri Balaji Action Medical Institute, New Delhi

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