Heart disease is often perceived as a condition that primarily affects men, but in reality, it is the leading cause of death among women as well. What complicates matters is that women tend to experience heart disease and its warning signs differently than men, which can delay diagnosis and treatment. Understanding these differences is vital to saving lives, and specialists such as Dr. Jai Bhagwan Dhull, a renowned cardiothoracic and vascular surgeon, emphasises the importance of recognizing gender-specific variations in heart health.
How Heart Disease Traditionally Presents
In men, heart attacks and other cardiac issues often present with the classic warning signs: crushing chest pain, discomfort radiating down the left arm, sweating, nausea, and shortness of breath. These “typical” symptoms have long been ingrained in public health campaigns and medical education. Unfortunately, this one-size-fits-all picture does not capture the way women often experience heart problems.
Why Women’s Symptoms Differ
1. Anatomical and Physiological Differences
Women generally have smaller coronary arteries compared to men. This makes them more susceptible to microvascular disease, where blockages occur in the tiny blood vessels of the heart. Such blockages may not always be visible during standard diagnostic tests designed for larger arteries. Hormonal differences, particularly fluctuations in estrogen before and after menopause, also play a role in how women’s cardiovascular systems respond to stress and damage.
2. Non-Classic, Subtle Symptoms
Unlike men, women may not experience severe chest pain during a heart attack. Instead, they might have:
- Unusual fatigue or weakness
- Shortness of breath, even at rest
- Discomfort in the neck, jaw, shoulder, back, or upper abdomen
- Nausea, indigestion, or vomiting
- Lightheadedness, dizziness, or unusual sweating
These subtle symptoms are often dismissed by women as minor health issues or stress-related, which delays them from seeking medical help.
3. Silent Heart Attacks
Women are more prone to “silent” heart attacks, where symptoms are mild or mistaken for non-cardiac conditions. This is particularly true for women with diabetes, as high blood sugar can alter how pain signals are perceived.
Risk Factors That Impact Women More
While high blood pressure, high cholesterol, smoking, obesity, and inactivity affect both men and women, certain factors increase women’s risks uniquely:
- Pregnancy-related complications: Conditions such as preeclampsia and gestational diabetes increase the likelihood of future heart disease.
- Menopause: After menopause, women lose the protective effects of estrogen, which raises their risk significantly.
- Diabetes: Women with diabetes face a disproportionately higher risk of heart disease than men with the same condition.
- Emotional stress and depression: These psychological factors are more common in women and can negatively impact heart health.
Challenges in Diagnosis
Women’s atypical symptoms pose diagnostic challenges. Many women themselves underestimate their symptoms, attributing fatigue or indigestion to busy lifestyles. Healthcare providers, too, may not always connect vague complaints with heart disease, leading to misdiagnosis or delayed treatment. Standard diagnostic tools and thresholds, developed largely based on male patients, may not be sensitive enough to pick up on heart disease in women.
This gap in detection underscores the need for physicians to be more vigilant when treating female patients. As Dr. Jai Bhagwan Dhull often stresses in his practice, awareness and careful evaluation of even subtle complaints can make the difference between early intervention and life-threatening complications.
The Importance of Gender-Sensitive Care
Recognizing the unique ways in which heart disease presents in women is the first step toward improving outcomes. Experts recommend a gender-sensitive approach to diagnosis and treatment, which includes:
- Asking detailed questions to uncover subtle or vague symptoms
- Considering microvascular disease when standard tests appear normal
- Using female-specific criteria in interpreting diagnostic tests
- Tailoring prevention and treatment strategies to women’s risk profiles
What Women Can Do
Awareness is key. Women should familiarize themselves with both the classic and non-classic symptoms of heart disease. Some proactive steps include:
- Paying attention to unusual fatigue, shortness of breath, or discomfort in the jaw, back, or abdomen
- Monitoring personal risk factors such as high blood pressure, cholesterol, diabetes, and pregnancy-related conditions
- Seeking immediate medical help if something feels “off,” even if it does not fit the stereotype of a heart attack
- Maintaining preventive habits like eating a balanced diet, exercising regularly, quitting smoking, and managing stress
Specialists such as Dr. Jai Bhagwan Dhull highlight that prevention and early recognition are just as important as treatment in reducing the burden of heart disease in women.
Why Timely Recognition Matters
When heart disease is overlooked or misdiagnosed in women, the consequences can be severe. Delayed treatment often results in greater heart damage, complications such as heart failure or arrhythmias, and a higher risk of mortality. Studies consistently show that women have worse outcomes after heart attacks compared to men, largely because of delays in recognition and treatment.
By contrast, when symptoms are recognized early and intervention is provided—whether through lifestyle changes, medication, or surgery—the chances of recovery improve dramatically. Dr. Jai Bhagwan Dhull’s clinical experience demonstrates that patients who seek care promptly and receive tailored treatment often have better long-term outcomes.
Moving Forward
The medical community is slowly shifting toward a more inclusive understanding of heart disease, recognizing that women’s experiences are not identical to men’s. More research is being conducted to refine diagnostic criteria, improve awareness campaigns, and design treatments that take gender into account.
Public health initiatives also need to spread the message that heart disease is not just a “man’s problem.” Women of all ages should be encouraged to prioritize their heart health, just as they would with other aspects of preventive care.
Conclusion
Heart disease is an equal-opportunity threat, but its face looks different in women. Subtle symptoms, unique risk factors, and diagnostic challenges combine to make women particularly vulnerable to under-recognition and delayed treatment. The good news is that awareness, preventive care, and timely medical attention can save lives.
Cardiac experts like Dr. Jai Bhagwan Dhull advocate strongly for educating both women and healthcare providers about these differences. By listening to their bodies, asking the right questions, and seeking timely care, women can protect themselves against the world’s leading killer.
Heart disease may be silent in its onset, but knowledge and vigilance give women the power to fight back—and win.