Cardiovascular conditions in women remain grossly underdiagnosed and undertreated. This could be partly because of the lack of sex-specific diagnostic criteria. While it is widely known that the female heart is smaller than the male heart, what is often ignored is that this has severe implications on a raft of cardiac parameters.

Delayed diagnosis can result in more aggressive symptoms than in men. It is absolutely critical to better comprehend the female heart and design sex-specific diagnostic parameters which would enable doctors to diagnose cardiac disease in women early, robustly and as reliably as in men.

Basic differences between women’s and men’s hearts

Size: In comparison, a woman’s heart and some of its chambers are smaller.
Density: The walls segregating some of the chambers are thinner, and the veins finer.
Function: A woman’s heart pumps faster than a man’s, while a man’s heart ejects more blood with each pump.
Stress reaction: In women, stress leads to a spike in pulse rate, causing more blood being pumped. In men, arteries tighten, leading to a rise in blood pressure.

Heart’s behavioural differences guiding treatment

In case of heart disease, men feel a more obvious crushing pain in their chest, while most women are likely to feel a passing pain in the upper abdomen or back, nausea, shortness of breath and perspiration.
Men diagnosed with heart disease are often a good decade younger than women diagnosed with heart disease. This could be ascribed to less identifiable symptoms in women compared to men, coupled with the fact that women often delay going to a doctor.
Post-menopause, women’s risk for heart disease goes up manifold.
Sudden cardiac death is more common among men.
Given the differences in the heart’s size and function, treating arrhythmia may require different types of medicines for men and women.
A family history of cardiac disease is critical for both men and women.
Women are more likely to feel heart palpitations.
Some conditions specific to women, like polycystic ovary disease (PCOD) and endometriosis, could raise the risk of coronary artery disease.
Heart attacks in women are often more devastating, and recovery could take much longer than in men.
Compared with men, women tend to have symptoms more often while resting.
Women are more likely than men to have a heart attack without a severe blockage in an artery.
Women tend to have blockages not only in their main arteries, but also in the smaller ones supplying blood to the heart.

Heart attack symptoms for women

While pain is the most common symptom of a heart attack among both men and women, very often, women tend to experience symptoms like a brief pain in the neck or back, or nausea that might seem totally unrelated to a heart attack.

Pain in the neck, jaw, shoulder, upper back or upper abdomen.
Shortness of breath.
Pain in one or both arms.
Nausea or vomiting.
Sweating profusely.
Dizziness or light-headedness.
Unexplained fatigue.
Indigestion or heartburn.