What are the warning signs of angina or a heart attack in women?

You have asked an excellent question. Unfortunately, many women believe that heart disease predominates in men and is less likely a threat to a woman's health than conditions like breast or ovarian cancer. The reality is that approximately 1 in 2 women will die from heart disease or stroke, and during any given year, cardiovascular disease will claim nearly twice as many lives as all forms of cancer combined.

While it is true that cardiovascular disease tends to strike men approximately 5 to 10 years earlier than in women, after menopause, the rate of cardiovascular disease in women accelerates and approaches the rate in men. Women are also at risk for doing worse after suffering a heart attack than men. Part of this may relate to the fact that women are typically older and have more hypertension when heart disease strikes and, thus, less able to withstand such damage to the body.

Other reasons, though, may relate to the fact that women tend to respond slower to symptoms or fail to recognize the symptoms as a heart attack, and present later for heart- and life-saving treatments. Because time to treatment is of the essence when heart attacks strike, delayed presentation significantly reduces the effectiveness of available treatments.

Recognizing your risk for heart disease is an important first step. In addition to age and family history, high blood pressure, high cholesterol, diabetes, smoking, obesity and physical inactivity all increase your risk for heart disease. Fortunately, effective therapies exist for each of these conditions, and taking such therapies when indicated can markedly lower your risk.

Symptom recognition is also essential. The typical symptoms of heart attack include chest pressure, tightness, or pain that may or may not radiate to your jaw, shoulders, or down your arms. If you are experiencing a true heart attack, these symptoms can come on at any time of the day or night, and can occur during rest or activity. The important consideration is that these chest sensations usually persist for more than 5 to 10 minutes (chest sensations resolving earlier than this time may be a warning sign not to ignore) and do not resolve with rest. Symptoms commonly associated include shortness of breath, clamminess, sweatiness and a nauseated feeling. Palpitations, light-headedness, profound fatigue, a heartburn-like sensation in the upper portion of your abdomen, confusion or agitation, and even a "heaviness" in your legs may occur.

Heart attacks may also occur in the absence of any of the above symptoms. Even earlier warning signs may be totally absent. Silent heart attacks are more common in older, typically female individuals, and those with diabetes, a history of smoking and prior heart disease. While these heart attacks are considered "silent," in reality, many individuals will complain of new ill-feelings, including shortness of breath, fatigue or nausea that arise over the span of several days.

Learning about the warning signs and ways of prevention of heart attacks is one of the first steps to fighting cardiovascular disease. Listening to your body when something does not feel right is the second. Discussing these issues with your doctor and understanding the ways of prevention will allow you to follow a personally tailored prevention program that maximally reduces your risk for the years to come.