Feb 7, 2014 — A heart attack affects men and women in the same way, but the different sexes experience the symptoms differently. Many women even dismiss the symptoms. Dr. John Ryan talks about why women’s symptoms are different, what symptoms women should look out for and why women shouldn’t dismiss heart disease as just a man’s health concern.

Interview

Host: Did you know that when women have heart attacks the symptoms are different from men? True. You're going to find out more about that next on The Scope. Medical news and research from University of Utah physicians and specialists you can use for a happier, healthier life. You're listening to The Scope.
I was surprised to find out that heart attack symptoms are actually different in men and woman. We're going to learn more about that right now with Dr. John Ryan, he's the director of the Dyspnea Clinic at the University of Utah. Men and woman, heart attack symptoms are different, is that true?

Dr. John Ryan: It's true to a certain extent, so the traditional concept we have of heart attacks being the crushing chest pain, hand on your chest, sweating, vomiting and presenting to the emergency department and be found to have a heart attack, is seen more commonly in men, however, part of the issue is is that women also experience these, but tend to ignore them more. So yes, they have the symptoms, but they just tolerate them better or dismiss them as being a heart attack, because many women don't feel that they're predisposed to a heart attack.

Host: So for example if you were to ask somebody what kind of pain you're feeling, one person might say it's a level ten, same amount of pain...

Dr John Ryan: Yes, exactly.

Host: ...number five, woman are doing the same thing with these symptoms.

Dr. John Ryan: Exactly, yeah, so there's a tendency to dismiss the symptoms, so therefore the symptoms often times need to be more severe or more advanced before woman present with them and then by the time they're more severe and more advanced, they're then different, so instead of having left sided chest pain or pain radiating down the left arm, they now have central chest pain and it's radiating down both arms. So that's what ultimately can make the syndromes different. Also, women often don't feel that they should have heart attacks.

Host: They don't have time.

Dr. John Ryan: Not only do they not have time, but it's a problem that men have. And this is a serious misconception because cardiac heart disease is the biggest cause of death of women in the United States.

Host: Which is a surprise to a lot of people.

Dr. John Ryan: Surprise to a lot of people and it's an important public awareness issue so therefore when women again, when they get their chest pains, or their symptoms from the heart attack, not only do they tolerate it more than men, but also they dismiss it as being a heart attack, sure, sure, why would I be having a heart attack, I'm a woman.

Host: Sure.

Dr. John Ryan: I don't have heart disease.

Host: Why do women dismiss, I mean, what is it about a woman's body that they tolerate it more? Any idea?

Dr. John Ryan: Probably a pain threshold issue.

Host: We've heard that before.

Dr. John Ryan: Exactly, yeah, woman often claim to have a higher pain threshold than men, and that's probably true and in this, and that's a very, that's an advantage, but ultimately that ends up hindering people in terms of presenting when they are having their heart attack. So that's probably the issue.

Host: The symptoms are the same but different, they experience them differently, but at the end of the day, are heart attacks different?

Dr. John Ryan: So the heart attacks are still associated with significant morbidity, significant mortality and so in that regard they are just as ominous and just as sinister. And the pains, again, the classical pains that people get or that people are taught, is that the central chest pain or the left sided chest pain, radiating down into the left arm, woman often times don't describe this as pain but will describe it as a pressure or a tightness in the chest, all of which are various adjectives that really impact how you perceive pain and again that reflects how you perceive pain. But ultimately the prognosis is still serious, still ominous, and still needs to be treated, taken very seriously and women need to be aware of the fact that they are as likely to experience cardiovascular events as men.

Host: Is there a take away that you would have?

Dr. John Ryan: Although we want to see patients when they're having heart attacks, we want to prevent patients from having heart attacks all together, so the more important aspect would be for women to be proactive in order to preventing events, so doing exercise, eating healthy, having heart smart diets and trying to, staying on top of their blood pressure, cholesterol and so on so that we don't end up seeing them when they've had a heart attack.

Host: We're your daily dose of science, conversation, medicine, this is The Scope, University of Utah Health Sciences Radio.