Heart attacks are ranked the number 2 killer in Singapore and can strike both men and women.
But did you know that women experience symptoms which are not so classical as compared to men and might even miss some “silent symptoms”?
Image source: iStock
theAsianparent spoke to Dr Kenneth Ng, a Cardiologist at Mount Elizabeth Novena Hospital, who explains that women do not always get the classical central crushing chest pain as men do, but instead may feel:
- Breathless or shortness of breath
- Dizzy or lightheaded
- Cold sweat
- Unusual fatigue
- Nausea or vomiting
- Gastric discomfort
- Pain in one or both arms
- Pain in the neck, jaw, shoulders, upper back or abdomen
“Silent heart attacks may also be more common in women. Women also seem to have less severe disease-causing symptoms as well as vasospasm in which there are no obvious coronary lesions. Women have a higher rate of false-positive stress tests for heart disease which makes preventative testing more difficult as the accuracy is lower”, he says.
Risk factors for women
According to Dr Ng, although women and men are at the same risk of getting heart disease, the only difference is that men’s risk of heart disease starts to rise once they hit 50 years old whilst women’s risk of heart disease only rises 10 years after menopause (i.e around 60 years old).
“Before menopause, women are well protected against heart disease by estrogen. The problem is that when you have a heart attack at an older age, then your risk of complications will be higher”, he explains.
Women who develop hypertension during pregnancy also have twice the higher risk of getting a stroke and 4 times higher risk of developing hypertension later in life.
Besides pregnancy complications and menopause being risk factors for women developing heart disease, there are some factors that actually put women at greater risk than men, such as stress, depression, diabetes, inactivity and smoking.
Women smokers are at higher risk of developing heart disease than men who smoke
Gender-specific tests to detect a heart attack in women
In a traditional diagnosis of heart attack for both men and women, it has been discovered that this method could actually miss detecting some women who have had an attack due to their lower levels of troponin I proteins in the blood.
When a heart attack strikes and causes damage to the heart muscle, these troponins I proteins are released in the blood — and the amount of such proteins released depends on the amount of damage to the heart.
The average level of troponin I for men is 1230 whereas for women is 50ng/L., so women who had heart attacks tend to have a lower troponin I level.
By using a gender-specific test with the cut-off of 16ng/L, the percentage of women who were diagnosed with a heart attack was 22% versus only 16% when using the generic cut-off of 26ng/L.
Dr Ng explains that by diagnosing more women with heart attacks, they will receive the appropriate treatment faster and expeditiously, so as to prevent complications and to promote recovery.
“If the diagnosis was missed, then the severe consequence will result. Hopefully, by using a lower cut-off, more women will be diagnosed and can get the appropriate treatment quickly, which will lead to better outcomes”, he says.
These gender-specific tests are available at most hospitals and specialist clinics in Singapore and can be done in conjunction with symptoms and a suspicion of a heart attack.
What to do if you have heart attack symptoms
Women generally tend to delay seeking medical treatment, so if you have experienced any of the symptoms of a heart attack, you should seek for help immediately.
Do not drive to the clinic or hospital yourself, but get a family member or friend to help send you there — although it is also advisable to call for an ambulance instead.
Remember not to brush off or ignore the symptoms because you never know if you could have just suffered a heart attack without even realising it.
The difference between a heart attack and a cardiac arrest
(Information contributed by Dr Rohit Khurana, Cardiologist at Gleneagles Hospital)
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