The Surprising Heart Health Threat to Women That’s Often Missed

By on September 26, 2016
Because women often have different symptoms of heart disease than men, our warning signs can be overlooked or misunderstood- even by our doctors, according to the American Heart Association.

By Vanessa Sheets–

Heart disease is the number one killer of women and is more deadly than all forms of cancer combined.

Because women often have different symptoms of heart disease than men, our warning signs can be overlooked or misunderstood- even by our doctors, according to the American Heart Association.

Small vessel disease is one type of coronary heart disease that affects primarily women and can be difficult to detect.

“We see microvascular disease in younger women, which sounds counterintuitive, but what’s happening is the plaque is spreading early through some of these tiny vessels first, before blocking the big arteries,” says Dr. Lawrence Vallario, a cardiologist with The Cardiovascular Center, P.A., at the Central Florida Regional Hospital.

Small vessel disease, also known as Syndrome X or microvascular dysfunction, interferes with proper blood vessel function. Instead of expanding to allow blood to flow through during exercise and physical or emotional stress, the diseased small vessels get smaller, or don’t dilate, causing reduced blood flow to the heart.

When a woman with Syndrome X shows signs of a heart attack, including chest pain, shortness of breath, and dizziness or sudden fatigue or weakness, her doctor is unlikely to find any narrowing in the bigger arteries.

“There’s usually no evidence of disease in the bigger arteries,” says Dr. Vallario. “Syndrome X is an early disease of the very small capillaries.”

And, they can begin blocking blood flow sooner than the big arteries, which explains why doctors see the disease in younger women in their 40s and 50s. This disease shows up first before the larger arteries have a chance to become affected.

Dr. Noel Bairey Merz, a cardiologist and medical director of the Women’s Heart Center at Cedars-Sinai in Los Angeles, describes the typical male heart attack as presenting with horrible chest pain, and using a catheter, doctors are quickly able to pinpoint the clot in the middle of a large artery and get rid of it. “That’s a man heart attack,” she says in her 2011 Ted Talk. She describes women as having more subtle symptoms, and different EKG findings. “So what do you think happens to these gals? They’re often not recognized, sent home. I’m not sure what it was. Might have been gas.”

Dr. Merz says that treatment for heart disease in women is 35 years behind. “We’ve worked on [better treatment for heart disease in women] for 15 years. We’ve been working on male-pattern heart disease for 50 years,” she says in her Ted Talk.

While we need better treatment and detection for women’s unique heart health concerns, lifestyle choices can reduce a woman’s risk of developing heart disease by as much as 80 percent.

Here’s how:

  1. Maintain a healthy weight. “There’s no question that obesity is a risk factor for developing Syndrome X or microvascular disease,” says Dr. Vallario. Try keeping a food diary and have a meal structure in place to prevent mindless snacking, which can lead to unwanted calories.
  1. Practice mind-body techniques to reduce stress. Prayer and meditation can help manage stress levels by reducing stress hormones that flood our system when we experience fight or flight reactions to emotional and tragic events. Deep breathing techniques and yoga are other mindful practices that can help reduce your risk of developing heart disease.
  1. Eat a whole foods diet. You’ve heard it said a million times that we should be eating plenty of fruits and vegetables, fish twice a week, and we need to reduce our sugar consumption for optimal heart health, and that’s true. But for years, we were also told to avoid fats. Not anymore. Researchers are increasingly finding that healthy fats, like avocados, egg yolks, olive oil, nuts, and Omega-3 fatty acids found in grass fed meats and salmon can reduce our risk of developing heart disease.
  1. Get enough vitamin D. Many of us have traded sunbathing for sunscreen, thanks to skin care recommendations to protect us from melanoma. But we need some sunlight exposure to make enough vitamin D, so make time to get outside regularly. A growing number of studies have linked vitamin D deficiency with increased heart disease risk. Talk to your doctor about supplementing if you’re concerned you’re not getting enough vitamin D in your diet and from exposure to sunlight.
  1. Exercise every day. Staying active by walking, swimming, playing tennis, and hiking reduces stress and lowers your risk for heart disease. Try to get at least 30 minutes a day of moderate physical activity.

A woman dies from heart disease every 80 seconds, according to the American Heart Association.

Make the necessary lifestyle changes so you’re not one of them.


Vanessa Sheets is a freelance journalist whose health articles have appeared in print and online magazines. Visit her website at

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The Surprising Heart Health Threat to Women That’s Often Missed