If you are experiencing a medical emergency, please call 911 or seek care at an emergency room.
Heart disease remains the number one killer of U.S. adults, and the number of young women having heart attacks—sometimes without realizing it—is increasing at an alarming rate.
According to a study published in Circulation, the number of heart attacks among young patients increased from 27% in 1995-1999 to 32% in 2010-2014. Among these young patients, the largest increase was among women, particularly Black women.
Seeing young patients in our heart clinic is no longer unusual—I see patients in their 20s and 30s who come to me with heart disease. Historically, most patients with cardiovascular disease tend to be over age 55, but it can happen to anyone.
For example, one of my young patients is a female health care professional who recently had a heart attack. Despite working in a health care environment, she delayed going to the hospital because of atypical symptoms and concern that she would be sent home with a diagnosis of heartburn or anxiety.
Her story is unfortunately common. For many years, heart disease and heart attack have been incorrectly perceived as “men’s diseases,” leading patients and providers to look for “classic” symptoms that present in men, such as crushing chest pain.
This unintended bias can lead to misdiagnosis. A 2016 study by researchers at the University of Leeds found that women in the UK have a 50% higher risk than men of receiving an incorrect initial diagnosis after a heart attack.
Another study found that women tend to delay going to the hospital by 30 minutes longer than men, often contacting friends and family for advice before turning to medical professionals.
Women and men can have different heart attack symptoms. Data from a 2022 study revealed that 62% of women do not have chest pain with a heart attack, compared to only 36% of men. Common heart attack symptoms in women can include:
- Cold sweats
- Burning or discomfort in the chest or upper abdomen
- Nausea and vomiting
- Pain or discomfort in the upper body (back, neck, jaw, arms, or stomach)
- Shortness of breath
These symptoms—and their crossover with other serious conditions—underscores the importance of seeking care when something doesn’t feel right. What might feel like heartburn or run-of-the-mill fatigue may be a heart attack or developing cardiovascular disease that could irreparably damage your heart.
Time is muscle for the heart.
The heart is a muscle, and once it’s damaged there is little we can do to repair it. Even if you have few or no symptoms, after the heart is damaged by an episode that cuts it off from oxygen the chances increase for heart failure, arrhythmias, heart attack, and disability.
If you have an identified heart attack or if you aren’t satisfied with your initial diagnosis, seek timely follow-up care as soon as possible. A primary care physician can help you control cardiovascular conditions such as high blood pressure, high cholesterol, or diabetes—and they can refer you to a cardiologist for specialized care to prevent or treat damage from heart disease as well.
At MedStar Health, we offer a Cardiac Rehabilitation Program that has been shown to increase the chance of living a longer, higher quality of life after a heart attack. Patients who participate in the program can achieve less pain, more strength, and a reduced risk of future heart events.
The holistic program is covered by most insurances and includes:
- Personalized physical therapy in our cardiac gym
- Specialized cardiovascular monitoring
- Nutrition and exercise education
- Weekly support group meetings
If you know you are at risk for heart disease, or if you have symptoms that are out of the ordinary, seek care from an expert. MedStar Health’s women’s heart disease risk assessment can help you better understand your heart health. You will receive a personalized risk score, which you can use as a conversation-starter with your doctor.
How to talk with a doctor about heart disease symptoms.
When it comes to heart health, you are your own best advocate. We recommend these tips for speaking up for yourself—and being clearly understood—in conversations with your doctor:
- Ask about symptoms, not conditions. Googling symptoms can result in pages of possible conditions you might have. However, 99% of the results may be wholly unrelated to your specific needs. Rather than saying, “I think I have X,” tell your doctor, “I feel like…” in order to get a timely, more accurate diagnosis.
- Ask for specific tests. If you feel dissatisfied with the initial diagnosis or exams, ask for a heart-specific test such as an EKG, which records electrical activity in the heart. If the doctor does not have the equipment or expertise for such tests, they can recommend a specialist who can help.
- Ask for a cardiology referral. Heart conditions can be complex to diagnose, particularly with subtle symptoms as is often the case for young women. A cardiologist has the tools and specialization to determine whether your symptoms are heart-related and set you on a path to prevent heart disease or manage existing cardiovascular conditions.
Understand your risk factors for heart disease.
Heart health is an ever-present concern, and lifestyle changes from the COVID-19 pandemic have increased the risk for many people around the world. Lockdowns and remote work have reduced activity levels, and comfort food, increased alcohol use, and poor sleep complicate matters.
Socialization also dipped during the pandemic, leaving many people lonely, anxious, or depressed. In Europe, providers cite social deprivation as a major risk factor for heart disease, and we’ve certainly experienced that in the last few years.
Along with the pandemic, there are many risk factors for heart disease we cannot control, such as aging and genetics. However, there are many more that we can control to an extent, such as working with a doctor to manage health risk factors including:
- Alcohol and tobacco use
- Excess body fat
- Blood pressure
As you work to reduce your heart attack risk, pay close attention to any symptoms that arise. It’s possible to do everything right and still develop heart disease due to risk factors outside your control.
Don’t second guess your impulse to seek care from a doctor. And if you feel like something is wrong, don’t stop asking questions until you have a satisfactory answer and a game plan to improve your heart health.