The Anatomy of a Heart Attack: Risks and Symptoms

When it comes to heart disease, not all symptoms — or risk factors — are created equal.

While heart disease is the leading cause of death for men and women in the U.S., it’s only in the last 20 years that researchers have studied how it manifests differently between the genders.   

Julio Panza, MD, Director of Cardiology at the Westchester Medical Center Health Network (WMCHealth), compares and contrasts the risk factors, signs and symptoms of heart disease in both men and women.

The Basics

The average heart:

• beats about 100,000 times per day and 35 million times per year.
• beats more than 2.5 billion times in the average lifetime.
• pumps 5 gallons of blood per minute and 2,000 gallons of blood daily

The heart is a complex organ and can be affected by diseases that impact the muscle, the valves or the vessels. Coronary artery disease, as a result of deposition of cholesterol in the wall of the arteries that supply blood flow to the heart, is the most common type of heart disease.

Shared Risk Factors: The Big Four

Men and women largely share the same risk factors for coronary -artery disease. The “Big Four,” according to Dr. Panza, are smoking, diabetes, hypertension and high cholesterol.

Another key risk factor is family history. Having a first-degree male relative who had a heart attack at age 55 or younger, or a female relative at age 65 or younger, increases risk.

Symptoms in Men

• Pain and pressure in the center of the chest
• Pain that radiates down the right arm, especially in cold weather, such as when snow shoveling

Diabetes: A Greater Threat to Women

Diabetes poses a far greater threat to the female heart. “The effect of diabetes on heart disease is much more pronounced in women than in men,” notes Dr. Panza.

Other Risk Factors for Women

• Stress
• Depression
• Autoimmune diseases
• Connective-tissue diseases, such as rheumatoid arthritis and lupus

“Connective tissue diseases are relatively rare,” says Dr. Panza, but among those with these conditions, heart disease is the most common cause of death.”

Symptoms in Women

• Vague discomfort in the chest
• Pain in the stomach, back, neck or jaw
• Shortness of breath
• Profuse sweating
• Palpitations

The “classic” symptoms of a heart attack — such as chest pain and radiating arm pain — may not necessarily be experienced by women. With women, many symptoms are less dramatic at first. Because these sensations can be more subtle, says Dr. Panza, “Women often tend to minimize the symptoms and wait too long for treatment.”