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Ask the Doctor: Bonnie Gainer, M.D.

Q: How is heart disease different for women vs. men?

A: Coronary artery disease, more commonly known as heart disease, continues to be the leading cause of death in women. A woman in her 60s has about a 1 in 3 chance of a heart attack in her lifetime.

In general, women tend to "lag" about 10 years behind men in their risk for a heart attack. But women, just like men, can have a heart attack even at a very young age particularly if they have a hereditary form of high cholesterol and early onset heart disease in their family.

A woman’s individual risk for a heart attack depends largely on risk factors that include having high blood pressure, diabetes, high cholesterol, a family history of early onset coronary disease, and of course, smoking. Smoking is in fact one of the most significant risk factors for a heart attack. A woman who smokes more than doubles her risk of a heart attack. Putting this another way, a 65-year-old woman who smokes but has no other risk factors has about the same chance of having a heart attack as a non-smoking woman with high cholesterol and diabetes.

Many people think that the symptoms of a heart attack present themselves differently in men and women, but that isn’t necessarily true.

Men and women have very similar warning symptoms, however women’s symptoms are more likely to go unnoticed because women are perceived as being at a lower risk for a heart attack than a man with similar symptoms.

But, there is definitely more awareness of this fact in recent years.

The “typical” symptoms of a heart attack tend to be described as a “heavy pressure” in the chest possibly radiating into the neck, jaw and arms and frequently brought on by exertion. The chest pain can be accompanied by other symptoms such as lightheadedness, shortness of breath and noticeable sweating. Sometimes, however, the symptoms are less “typical” and may be more subtle such as “indigestion” or shortness of breath that is new or out of proportion to level of exertion.

Staying on top of your heart health is extremely important. It is prudent to have a medical checkup, even as a young adult, to check for high cholesterol, high blood pressure and possibly diabetes, depending on family history.

Bonnie Gainer, M.D., is a Board Certified cardiologist and has been in practice at Hoag since 1992. She was the first female cardiologist on staff at Hoag and was one of the founding members of the Newport Heart Medical Group at its inception in 1994.