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Research Finds Heart Disease Symptoms Are More Nuanced in Women

woman holding a heart

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Key Takeaways

  • Cardiovascular diseases come with a range of symptoms and manifest differently in men and women.
  • The lack of research on how heart disease symptoms develop in women often leads to misdiagnoses or late diagnoses.

Symptoms of cardiovascular disease can manifest differently in men and women. But many providers don’t have a good grasp on how to recognize the warning signs in women—a problem rooted in gender bias in medical research, which has primarily focused on White men.

This limited understanding about how women’s symptoms develop and progress often interfere with their diagnoses and access to care.

In a new review published in Circulation, researchers outlined the differing symptoms between men and women in six common cardiovascular conditions, including heart attack, heart failure, stroke, and more.

“We know less about women and people that are nonbinary in terms of their cardiovascular symptoms, because we haven’t studied them as long and in many instances in sufficient detail,” said Christopher S. Lee, PhD, RN, a cardiovascular nurse scientist and a coauthor of the review.

The researchers said they hope the findings can equip both patients and practitioners with the tools to recognize early warning signs and individualize care.

Lee said that the varying symptoms can be explained by both biological differences and gender roles. For one, the female heart is smaller than the male heart in relation to the chest, which can affect how symptoms surface. And women are often expected to be caregivers, which might increase their levels of stress and daily activities.

How Are the Symptoms Different in Women?

Across most of the six conditions reviewed, women showed a wider range of symptoms than men.

For example, women who experience a stroke may display symptoms like headache, altered mental state, a coma, or stupor, which are not typically noticed in men. When it comes to cardiac arrhythmia —or irregular heart rhythm—women and younger adults are more likely than older men to experience heart palpitations.

Women with valve disease are also more likely to experience chest pain or shortness of breath than men.

Further, there’s a misconception that women are less likely than men to have peripheral artery disease (PAD), a buildup of fat and cholesterol in the arteries that carry blood to the arm or leg. PAD in women can also be confused with osteoarthritis, the most common type of arthritis.

Generally, people with PAD may have no symptoms or have pain in their calf muscles. However, women with PAD are more likely than men to report pain in other parts of the leg or have no symptoms at all, according to the research.

As such, a young woman may not be flagged for a cardiovascular condition, even if she comes to the emergency room with tell-tale symptoms, said Corrine Jurgens, PhD, RN, a coauthor of the review and PhD program director at Boston College’s Connell School of Nursing. If the woman experiences a lesser-known cardiovascular disease symptom, she may not go to the ER at all.

“Not all providers are comfortable with assessing the risk profile for women, whereas we all pretty much agree what it is for white men,” Jurgens told Verywell.

When to Seek Treatment

There is no magical age when people should seek assessment for cardiovascular disease, Jurgens said, but it may be earlier than they think.

“If it looks like a duck and it quacks like a duck, it’s probably a duck,” Jurgens said. “We don’t want to wait for symptoms.”

She recommends seeking treatment if you have a family history of heart disease or notice symptoms, regardless of your age.

For those without a family history of heart diseases, obsessing over such a long list of symptoms can get overwhelming. But some symptoms are more concerning than others, according to Nicole Weinberg, MD, a cardiologist at Providence Saint John’s Health Center in Santa Monica, CA.

For instance, experiencing chest pain after eating a spicy meal may not be a sign of a heart condition, whereas experiencing chest pain during exercise could be concerning, Weinberg said.

Additionally, symptoms of congestive heart failure tend to be worse when you’re lying down. For coronary artery disease, the symptoms are likely worse with exertion and improve when you’re at rest, she explained.

If you experience multiple symptoms related to heart conditions, it might also be more worrisome than having one standalone symptom.

“Patient care is about thought: It’s about listening to the patient, talking to them, figuring out what’s been going on in their universe,” Weinberg said. “That’s better than any test you can do to try to figure out what is causing their problem.”

Hope for Heart Healing

Going forward, increasing understanding and recognition of sex-based cardiovascular disease symptoms may be crucial for saving lives and helping patients manage their conditions.

One of the purposes of the review was to raise a “renewed commitment to symptoms being an important part of clinical care,” Lee said.

“There have been some great advances in medical therapies for cardiovascular diseases, but symptoms have always been and will continue to be a very important part of the assessment and the diagnosis of the illness,” he added.

And after diagnosis, people can get the help they need, he said.

“There are phenomenal treatments for almost all the conditions that we mentioned, especially if they’re caught early,” Lee said. “Instead of viewing these as fatal events, [we can] rethink what chronic cardiovascular disease looks like.”

What This Means For You

Symptoms of cardiovascular disease can vary in men and women, ranging from loss of appetite to shortness of breath. Health professionals encourage people to get screened for cardiovascular disease if they experience symptoms or have a family history of heart conditions.

1 Source
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jurgens CY, Lee CS, Aycock DM, et al. State of the science: the relevance of symptoms in cardiovascular disease and research: a scientific statement from the American Heart Association. Circulation. Published online August 18, 2022. doi:10.1161/CIR.0000000000001089

By Claire Wolters
Claire Wolters is a Philly-based reporter covering health news for Verywell. She is most passionate about stories that cover real issues and spark change.