Cardiovascular disease is the leading cause of death for women worldwide. Yet, it remains understudied, under–diagnosed, and under–treated.
While women are almost 50 per cent more likely than men to be misdiagnosed after a heart attack, heart disease is often considered to be a ‘male issue’.
To understand why this gap still exists and to shine a light on the topic, Dr. Caoimhe Hartley, Clinical Lead Women’s Medicine and GP sat down with Consultant Cardiologist Dr. Sorcha Allen as part of the ‘Her Health’ series from Blackrock Health.
The podcast, Heart Health in Women: When Symptoms Are Missed, Dismissed or Delayed explores critical, nuanced conditions that significantly impact women’s lives.
‘If you polled people on the street, very few would know that more women die of heart disease every year than men,’ says Dr Sorcha Allen.
‘Historically, the very large clinical trials conducted over the last 20 to 30 years predominantly focused on men.
‘Consequently, medical training was built on the foundation that heart disease impacts men over the age of 55 with specific, “typical” risk factors.
‘This has led to the misconception that heart disease isn’t a “woman’s issue” in the same way breast cancer or menopause is.
Things to watch for: checking blood pressure is important
‘We are taught to look out for typical heart disease symptoms such as central, crushing chest pain radiating to the jaw or left arm. While some women do experience this, the vast majority present with much more subtle symptoms.
‘Because they don’t look like the “classic” male presentation, they can be dismissed or result in delayed diagnosis. In cardiology, we are trying to move away from the terms “typical” and “atypical”, because “atypical” symptoms are completely typical for half of the population,’ she adds.
Profound fatigue and a decrease in the ability to exercise are two of the main symptoms Dr Allen sees in the course of her work.
‘Shortness of breath and sleep disturbances are also highly common, particularly in the two weeks leading up to a heart attack.
When women do experience chest discomfort, they often describe it not as crushing pain, but as a band–like pressure, or even as something resembling indigestion or heartburn in the upper abdomen,’ says Dr Allen.
She adds that women are far more likely to have their symptoms dismissed or attributed to anxiety, gastrointestinal issues like indigestion, or musculoskeletal pain which can contribute to worsened outcomes in the long–term.
Dr. Allen says there are three things women can do to help themselves.
‘Firstly Get your blood pressure checked regularly. Do not write off high readings as “white–coat hypertension” – if it’s high, it needs to be managed,’ she says.
‘Talk to your doctor about your family history of early heart disease, any pregnancy complications you experienced, and any autoimmune/inflammatory conditions (like rheumatoid arthritis or lupus) you may have.
‘And thirdly focus on eating whole, fresh foods 80% of the time, and avoid ultra–processed foods. When it comes to exercise, consistency is key. You don’t need to run marathons; 20 to 30 minutes of brisk walking five times a week is phenomenal. Additionally, include weight–bearing or resistance exercise to protect your bones and muscles.
‘Most importantly, listen to your body and advocate for yourself. Women are highly prone to minimising their symptoms because they are busy caring for children, careers and aging parents.
‘If you feel exhausted, breathless, or just “off,” do not dismiss it. If you feel like your concerns are being brushed aside by a doctor, seek a second opinion. No one will ever fault you for ruling out a serious cardiac issue.’
- You can listen to the ‘Her Health podcast with Dr Sorcha Allen and Dr Caoimhe Hartley on all podcast platforms.
