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Change of women’s heart

December 12th, 2013


Change of women’s heart

I am a guy who can confidently say that I have been troubled by how women’s heart changes so much. Now, it’s not just because I am from Mars and they are from Venus. Ladies, please don’t write me off as an insensitive guy just yet!

What I mean is that I, as a cardiologist, have witnessed the complexity of women’s heart. When something is wrong a woman’s heart, it is quite hard to diagnose, and even harder to treat. This is a fact acknowledged by many cardiologists worldwide. Perhaps it is because most cardiologists are male, although female cardiologists are rising in number.

The first difference I would like to use as an example is the blood vessels, whether the coronary artery or cerebral arteries. Now, I don’t mean to be discouraging, but in the US, about 500,000 women lose their lives to coronary artery disease, more than 7 other causes combined. Moreover, each minute, a woman dies from heart disease. They always say women age quickly but live long. It’s not always true, except for the first part.

While modern medicine means that coronary artery disease can be treated efficiently, meaning people do not die from the disease as much as in the past, comparing male and female patients, the females still stand higher chance of not recovering.

Is it a cruel joke by Mother Nature? Is there something about women’s habits that causes it? It is hard to tell.

There are some disadvantages that stemmed from ancient belief that coronary artery is a men’s disease. If women showed signs of this disease, they were usually dismissed. How dare you woman claim you have a disease that only men could have?

Although this belief is fading away as gender equality is improving, its effect still lingers, because most of the research and information usually include only male patients. There are a lot of unknown factors about women. Something that works on a male patient can be ineffective on a female patient. Maybe playing hard to get and being mysterious is a part of their nature, after all.

Another interesting point is the tipping point that sends the patient to the doctor. Most men would experience pain or tightness in the chest, while women with the same disease would come to see the doctor because they feel pain in their shoulders, neck or stomach. Sometimes they also have confusing signs, such as other kinds of chest pain that are not related to heart disease.


See how my life has been complicated by women? Although men and women are mostly alike, there are still differences. The first is that women’s hormones could help prevent narrowed artery, and while their hormones are still functioning well (before menopause), the chance of developing narrowed artery disease is slim. But as soon as menopause hits, men and women are equal in terms of the risk.

A large-scale research tried giving estrogen and progestin to menopausal women, hoping to reduce the chance of coronary artery disease. The result turned out to be the opposite – they were more likely to die from heart disease, especially in the first few years. Talk about unpredictability!

Physically speaking, women’s body tends to work too hard. The blood platelets work more, meaning inflammation is more likely, resulting in heart problems. Women are 5-7 times more likely to develop artery problems related to narrowed artery disease than men.

Women’s moods are also not very stable, and they have very complicated thoughts, resulting in stress and depression which negatively affect the treatment and recovery.

Now you would probably ask, are you just going to sit there and criticize me without offering any solution?

Of course I have options, and I believe I can say that I am asking this on behalf of cardiologists in general. These options could help save you from coronary artery disease, or from making it more severe than it already is. What I am telling you now is very basic but not easy.

Solution 1: Quit smoking and avoid surrounding yourself with cigarette smoke. If you live with a smoking husband, either get him to stop or avoid being near him when he smokes.

Solution 2: Exercise moderately but frequently. Thirty minutes a day, as many days as you can in a week, does the trick.

Solution 3: Stick to heart-healthy diet, including fruits, vegetables, grains, fish, and low-fat dairy products. High-protein, low-fat food such as chicken breast or soy protein is good, too, but make sure it is not too salty.

Solution 4: Keep your weight in a healthy range, meaning your BMI index should be around 18-23. Your waist line should never exceed 32 inches. If it is more than 32 inches, use Solution 2 and 3 to trim it down.

Solution 5: As soon as there are signs of emotional problems, seek help immediately before the situation spirals out of control.

Solution 6: Annual health check-up can detect signs of heart disease early, and when a problem is not yet severe, it is hard to treat. Other factors such as blood pressure, blood sugar level and cholesterol level are also important.

While women have a heart that confuses me, I am sure that women’s heart is strong and determined enough to stay on a healthy route. Otherwise Nature wouldn’t have trusted women to take the big responsibility of being a mother!


Prof Nithi Mahanonda is consultant cardiologist and interventionist, Perfect Heart Institute.


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