Symptoms of a Heart Attack or Stroke in Women

Cardiovascular disease, which includes coronary artery heart disease and stroke, is the leading cause of death of American women.  Statistics show that men and women have different outcomes from this disease.  Women are more likely than men to die from heart disease and more women die from stroke than men.  However, a misperception still exists that cardiovascular disease is not a real problem for women.

Coronary Artery Disease (CAD)

Typical angina symptoms, which usually occur in men, are:

• Uncomfortable pressure, fullness, squeezing or pain in the center of the chest
• Discomfort may radiate to the arms, jaw, neck and back

Atypical angina symptoms, which usually occur in women, include:

• Abdominal pain
• Shortness of breath
• Unexpected fatigue, dizziness, or weakness
• Nausea
• Clamminess, cold sweats
• Anxiety

Women are more likely than men to have a hidden type of heart disease, which can present with chest discomfort, slight ECG abnormalities or abnormal stress tests. However, normal arteries are found on angiography x-rays.  This hidden cause of heart disease does not involve the larger arteries supplying the heart (as is typical in men), but is due to an abnormal lining of the small branches of the coronary arteries called the micro vessels.   High blood pressure, tobacco smoking, high cholesterol and diabetes can cause abnormal function of the artery lining.  This syndrome is diagnosed by ruling our other cardiac and non-cardiac causes of chest pain.  Medications and lifestyle changes can relieve the symptoms. Medications to control blood pressure, cholesterol and aspirin may be recommended. 

Other causes of chest discomfort that are not related to the heart include acid reflux (heartburn or GERD), inflammation of the chest wall (costochondritis) or lung inflammation. If you have episodes of chest discomfort, you should see your physician for an evaluation.  An EKG, stress testing and echocardiograms may be necessary to evaluate the symptoms and establish the diagnosis.

Cerebral Vascular Accidents (CVA) or Stroke

CVA includes stroke and TIA (transient ischemic attack or ‘minor stroke’) and occurs when there is a sudden interruption in the blood supply and oxygen to the brain.

There are two main types of strokes:

•  Ischemic strokes are due to sudden blockages by ruptured plaque. 85% of strokes are ischemic
• Hemorrhagic strokes are due to bleeding from a ruptured blood vessel within the brain

Stroke warning signs include:

• Sudden numbness or weakness of the face, arm or leg, especially on one side of the body
• Sudden confusion, trouble speaking or understanding
• Sudden trouble seeing in one or both eyes
• Sudden trouble walking, dizziness, loss of balance or coordination
• Sudden severe headache with no known cause

Strokes affect people in different ways, depending on the type of stroke, the area of the brain affected and the extent of brain injury.

TIA’s or transient ischemic attacks are “mini” stokes that produce stroke-like symptoms, but cause no lasting damage.  The symptoms of a TIA last a few minutes to several hours and completely resolve within twenty-four hours.  More than one half of people who experience a TIA will later have a stroke.  Heeding the warning signs of TIA’s and treating the underlying risk factors for cardiovascular disease could prevent many strokes.