Heart problems and heart attacks are often not recognized in women

Heart attack is a big danger even in women

Whether myocardial infarction, coronary heart disease or insufficiency: cardiovascular diseases are the most common cause of death in the western industrialized countries. It is often assumed that especially men are particularly affected. A dangerous mistake, because women also most often die from heart disease. On the occasion of the World Heart Day on 29 September, experts now want to provide information.

Heart attack death rate drops by half in men
Still in Germany still more men than women die of a heart attack (med .: myocardial infarction). As can be seen from the current "Heart Report", in 2012 there were almost 29,000 men and around 23,600 women who fell victim to an infarct. Despite the higher numbers, however, this is no longer a pure "men's business" anymore: While the number of deaths per 100,000 inhabitants (death rate) among men has been reduced by about half in the last 30 years, it only fell in the case of women one third.

Women have other complaints than men in a heart attack. Picture: Kzenon - fotolia

According to the German Heart Foundation e.V., more women will die of heart disease than men, if deaths from heart valve diseases, heart failure and arrhythmias are called in. However, these are usually about ten years older than the male fatalities, explains Professor Thomas Meinertz, Chairman of the German Heart Foundation, told the news agency "dpa". According to the experts, the reason for this is the production of the female sex hormone estrogen. Because this protects apparently before the menopause, the blood vessels of women from the dreaded arteriosclerosis - and thus against vasoconstriction and myocardial infarction.

Women tend to have a heart attack in old age
If hormone production in the ovaries decreases after menopause, however, the risk of cardiovascular diseases rises sharply. Accordingly, the curves would converge in men and women from about 75 years, according to Professor Meinertz. "Women have much less cardiovascular disease before menopause than men and more after menopause," explains Professor Vera Regitz-Zagrosek to "dpa". According to the expert, who runs the Institute for Gender Research in Medicine at the Berlin Charité, women would rather have an infarct at an advanced age. "However, we do not yet know how much of the observed effects with age and how many are hormonal", because the proportion of women in large heart studies was still too low according to Regitz-Zagrosek.

Obesity and high blood lipids are equally dangerous in both sexes
But despite the rising numbers in old age, the danger would often be underestimated, warns the expert. "Women believe that they are protected from cardiovascular disease by hormones, as they were once told." After the menopause, however, the risk is just as high and the most important risk factors are between the sexes do not differ. These include obesity, high blood lipids and high blood sugar, which is even more of a threat to women, says Regitz-Zagrosek.

Also more and more women under 60 years affected
But not only women after menopause are affected. Instead, more and more women under 60 years or before the last spontaneous menstruation would suffer a heart attack. A "disconcerting" trend from the expert's point of view - even though this is not the largest proportion of infarction patients. From a medical point of view, smoking was a major risk factor at a younger age, as women were less likely to be deterred by anti-smoking campaigns than younger men.

Diabetes in pregnancy can increase risk of cardiovascular disease
In addition, women are more susceptible to specific forms of stress-related heart disease and diseases of the small coronary arteries. Likewise, gender-specific risk factors would play a role. Because evidently, e.g. Hypertension or diabetes in pregnancy lead to an increase in the risk of old-age cardiovascular disease, says Regitz-Zagrosek. How exactly these relationships are to be explained, however, has not yet been clarified scientifically. "But they are observations that are backed up and important in large studies," emphasizes the expert.

"Women and heart disease have been underestimated," sums up the trained cardiac surgeon, Professor Sandra Eifert, from the Klinikum Großhadern in Munich. According to the expert who
caring for heart failure and women-specific consultations, "women's complaints [.] are often not taken seriously." It is important that, for example, An infarction in a woman can express very differently than a man. "One always learns in the study that the heart attack with chest pain and pain behind the sternum radiating to the arm or lower jaw begins," explains Eifert further in conversation with the "dpa".

Nausea and upper abdominal discomfort as myocardial infarction signs
These typical complaints can also occur in women - but they do not have to. Instead, in some cases, female patients would be more likely to suffer from "relatively nonspecific" symptoms, such as nausea and upper abdominal discomfort, which could make the diagnosis last longer than the "classic" heart attack symptoms. Similarly, it behaves partly in cardiac catheterization, because even here, according to Eiferts "may not all aspects of a disease discovered" - which concerns especially the small coronary arteries.

Because in some women, the blood pressure falls after a Gefasstgstelle not as massive as in the men, but only gradually. Complaints that arise as a result, would accordingly incorrectly age or similar. attributed.

"The women are getting cardiac catheters these days, and then you often do not notice anything and they are sent home," Eifert continued. However, this does not rule out the possibility that there may still be a hereditary vascular disease. In order to be able to recognize smaller or more subtle vascular changes, women should therefore be examined with further developed methods, e.g. Functional Magnetic Resonance Imaging (fMRI).

Mortality in cardiac arrhythmias and valve diseases is increasing continuously
According to the German Heart Foundation, millions of people in Germany are suffering from heart disease. Since 2000, the mortality rate for cardiac arrhythmias and valve diseases has been steadily increasing. "That's why the Heart Foundation's educational activities are essential for reducing mortality and inpatient admission because of heart disease - in addition to medical care in clinics and practices -" emphasizes Prof. Meinertz. (No)