“A woman is not a small man,” says cardiologist Nathalie Meyten. “That sounds very logical, but until a few years ago, the medical world still too often assumed this. A woman’s heart looks the same as a man’s, but there are functional differences that you have to pay attention to as a doctor, otherwise you miss potential problems.”
Cardiovascular diseases are nowadays more common in women than in men, Meyten says, and in women they are even the number one cause of death. As a result of emancipation, more and more women have become more susceptible to the risks that in the past mainly men were subjected to: a stressful life, smoking, being overweight.
“In addition, there are also specific risks for women, which were previously too little taken into account,” says Meyten. “For example, use of the pill and the development of high blood pressure or diabetes during pregnancy. Those problems can be predictive of cardiovascular disease later in life.”
One very important factor: the menopause. “Before the menopause, estrogens protect against arteriosclerosis, after that women are much more susceptible to cardiovascular disease. More sensitive than men. Women usually have to deal with it a little later, but if they have a heart attack or stroke, it’s often more deadly.”
Stress
Women themselves recognize too little the symptoms of constructive cardiovascular problems, and unfortunately not always their doctor. “Did you know that women who have a heart attack call the emergency services on average 21 to 22 minutes later than a man? It is not so clear to them what is happening, while time is very precious in such a case. The less time that is lost, the less damage the heart suffers,” explains Meyten.
“While men are more likely to experience the typical chest pressure, with pain radiating to the arm and jaw from a coronary clot, in women the problem is more often in the small blood vessels. This manifests itself in palpitations, fatigue, sleeping problems, hot flashes. Women are more likely to explain this with ‘it must be the stress’ or ‘just the menopause’. Those are death eaters. What’s worse is that cardiologists, mostly men, usually agree. This is followed by a standard examination, but female heart problems are not always recognized with this. So that can be really dangerous.”
Acute stress is not a disease in itself, Meyten says, but women are more sensitive to it and it is a trigger for cardiovascular disease. — © Shutterstock
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Acute stress is not a disease in itself, Meyten says, but women are more sensitive to it and it is a trigger for cardiovascular disease. “In the most extreme case, intense emotions release so many stress hormones that the arteries constrict and narrow to such an extent that much less blood can pass through, which can lead to a heart attack,” the cardiologist knows.
“The last time I saw it was with a woman who found her daughter committing suicide. But you also see it in loved ones, then it is also called broken heart syndrome. The heart then takes on the typical shape of a tako tsubo, a Japanese pitcher. Hence the name takotsubocardiomyopathy. The good news is that it can be cured with medication if treated quickly.”
Annual control
Meyten recommends women in the menopause to see a cardiologist annually for a check-up. “By controlling your cholesterol, losing weight and lowering blood pressure, you can prevent a lot of misery.”
But also women who have had multiple miscarriages and with conditions such as migraine, rheumatism and Crohn’s disease should go to a heart specialist. “Those diseases cause inflammation and arteriosclerosis is an inflammatory process. That makes them much more susceptible to cardiovascular disease. And once there is damage, unfortunately often follows a life in pajamas, as we say: hospitalizations for ever more problems. So, on Valentine’s Day, take a moment to reflect on the woman’s heart.”
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