Thursday, July 22, 1999
Young women face unique heart risks
BY SUE MacDONALD
The Cincinnati Enquirer
Premenopausal or middle-aged women are twice as likely as men to die in the hospital after a heart attack — and the younger the woman, the higher her risk, according to today's New England Journal of Medicine.
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WOMEN'S HEART ATTACK SYMPTOMS
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• Chest pain, tightness or squeezing in the chest.
• Chest pain during physical activity; pain that occurs at night or in the morning but subsides during the day.
• Pain radiating through the chest, back, shoulders, jaw, arm, below the rib cage, abdomen.
• Nausea, indigestion, sweating.
• Heart palpitations or “fluttering” heartbeat.
• Fatigue, shortness of breath, difficulty breathing, lightheadedness.
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Women in their 30s to 60s should be considered a “high-risk group deserving of special study,” because the underlying causes, symptoms and outcomes of their heart attacks can vary from men's, according to two studies, one from Yale University and one from St. Luke's- Roosevelt Hospital Center in New York City.
The studies should motivate doctors to redefine and expand their knowledge of women and heart disease, said Dr. Laura Wexler, a cardiologist at University of Cincinnati Medical Center, in a companion editorial.
Of interest, she said, is the role estrogen or other sex hormones might play.
The Yale University study compared the heart attacks of 156,000 women with 229,000 men. It found that overall hospital death rates were 16.7 percent for women and 11.5 percent for men. Women under 50 were more than twice as likely to die as men.
By age 74, women's and men's outcomes were similar.
Other study findings:
• Women's heart attacks are less likely than men's to be caused by clogged or blocked arteries. Since many screening tests look for blocked blood vessels, this may explain why heart disease is misdiagnosed or underdiagnosed in women.
• Women with chest pain typically waited longer than men, sometimes six hours or more, to go to the hospital and were less likely to be diagnosed with a heart attack once there.
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