Q&A on angina in women

Dallas cardiologist Dr. Farhana Kazi answers questions about angina and other heart diseases in women.

Q. What’s the biggest misconception about women and heart disease?

A. A big misconception these days is that women are protected from heart disease. In reality, women have as much heart disease as men. It’s changed from just a few years ago; back when I was training, we’d see men coming in for heart disease in their 30s and 40s, but usually we wouldn’t see women until they were postmenopausal.

Now, with the growing prevalence of hypertension, obesity, and diabetes, we’re seeing a lot of heart problems in women at a very young age. All the classic risk factors – cholesterol, hypertension, and smoking – affect women just as much as men.


Q. Why do women often experience symptoms of heart disease, such as angina (chest pain), differently than men?

A. Lots of data show that women have more atypical symptoms than men. Women may have angina, or chest pain, but it’s not always the crushing chest pain that men have. It could feel more like indigestion, nausea, jaw or elbow pain.

We don’t know exactly why this is the case. It could be anatomical differences, such as differences in the complex of nerves that innervate the heart; and women’s brains may process some of this information differently than men’s brains. And maybe there’s a true chemical reason, such as the effect of estrogen in the body. But it’s clear that men and women’s bodies are definitely different in terms of symptoms of heart disease.


Q. Why are women resistant to talking about their heart disease symptoms?

A. Many women don’t make their health a priority. A lot of women I see are in executive positions; they are extremely focused on their career and don’t want to spend time on their health. Often, I see women with kids, and these moms are very busy. Maybe they’ve gained weight after pregnancy and are now hypertensive or diabetic. Or maybe they’re having symptoms such as chest pain when they walk, but they can’t find time to take care of themselves. Some patients may not even have heart disease yet; they may just need help addressing other risk factors. And I’m here to help.

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