Heart Disease UK

From Richard N. Fogoros, M.D.
By DrRich

In standard textbooks of cardiology, much space is devoted to a description of the symptoms that typically occur with heart disease. In most cases, these "typical" symptoms turn out to be a recitation of the symptoms men get. In women, the symptoms can be quite different, and are usually regarded by cardiologists as being "atypical." However, since more women are dying from heart disease than men these days, it may be statistically more correct to consider men's symptoms as the ones that are "atypical."

Angina in women
When women have angina, they are more likely than men to experience "atypical" symptoms. Many women report a hot or burning sensation, or even tenderness to touch, in the back, shoulders, arms or jaw; often they have no chest discomfort at all.
Any good doctor will think of angina whenever a patient describes any sort of transient, exertion-related discomfort located anywhere above the waist, and they really shouldn't be thrown off by "atypical" descriptions. However, because many doctors persist in believing that CAD is uncommon in women, they are all too likely to write such symptoms off to mere musculoskeletal pain or gastrointestinal disturbances.
Myocardial infarctions (MI, heart attacks) also tend to behave differently in women. Frequently they experience nausea, vomiting, indigestion, shortness of breath or extreme fatigue - but no chest pain. Unfortunately, these symptoms are easy to attribute to something other than the heart. Women also are more likely than men to have "silent" MIs - that is, MIs without any acute symptoms, and that are diagnosed only at a later time when subsequent cardiac symptoms occur.

Chest pain with normal coronary arteries
Furthermore, women are more likely than men to experience true angina (chest pain due to a coronary artery disease) but with "normal" coronary arteries seen on cardiac catheterization.

Women minimize their symptoms
Women tend to complain less about their cardiac symptoms than men, thus leading doctors to think they are doing better than they actually are. Now, scientific evidence exists to show that, indeed, women tend to minimize their symptoms of cardiac disease.