Women's heart: Why female heart health requires special consideration

The topic Heart and women is increasingly becoming the focus of modern cardiology, as we now know that cardiovascular diseases often manifest themselves differently in women, have different causes and require adapted treatment. For a long time, heart health was primarily researched from a male perspective, which led to gaps in knowledge that can be life-threatening for women. In our practice, we take gender-specific differences seriously and offer cardiology that recognizes women in all their biological and biographical uniqueness.

Heart & Women: A long underestimated risk

Cardiovascular diseases are not a „men's problem“. On the contrary: they are also the number one cause of death in women - even before all cancers combined. Nevertheless, the personal risk is underestimated by many women and sometimes even by doctors. The reason for this often lies in the protective effect of the female hormone oestrogen before the menopause. However, this protection is not absolute and ends abruptly with the menopause. After that, the risk of heart attack and stroke increases even more steeply in women than in men. A discussion of the topic „Heart“ is therefore of crucial importance for every woman at every stage of her life.

Heart attack in women: Recognizing other symptoms

Probably the most important and best-known topic in gender-sensitive cardiology is the different symptoms of a heart attack. While men often experience the „classic“ crushing pain in the chest radiating to the left arm, the signs in women can be far more subtle and atypical. These „atypical“ symptoms are often misinterpreted as an upset stomach, stress or flu-like infection, leading to a dangerous delay in life-saving treatment.

Watch out for these warning signs, which occur more frequently in women:

• Severe, inexplicable tiredness and weakness, that can build up over days.
• Shortness of breath, often even with little exertion or at rest.
• Feeling of pressure or tightness in the upper abdomen, back (often between the shoulder blades) or in the jaw.
• Nausea and vomiting for no apparent reason.
• Dizziness, drowsiness and cold sweat.
• A general feeling of Fear and anxiety.

Important: Women can also have classic chest pain. But if several of the above symptoms occur suddenly and with unusual intensity, do not hesitate and call 112 immediately. It could be your heart!

Risk factors with particular significance for the female heart

In addition to the classic risk factors such as smoking, high blood pressure and diabetes, there are a number of risk factors that exclusively or predominantly affect women. Knowing these and addressing them in medical consultations is an important aspect of prevention in the area of Heart women.

Specific risk factors for women

Heart and women in different phases of life: From the pill to menopause

Women's heart health is closely linked to their hormonal life cycle. There are specific aspects to consider at every stage of life.

• Young women: The choice of contraceptive method („pill“) can influence the risk of thrombosis and stroke if other risk factors (smoking, migraine with aura, coagulation disorders) are present. A careful medical history is important here.
• Pregnancy: Pregnancy is an enormous strain on the cardiovascular system. Blood pressure and blood sugar must be closely monitored. Any complications that arise are important warning signals for the future.
• Menopause: This is a critical phase for female heart health. The loss of oestrogen protection requires more intensive monitoring and, if necessary, adjustments to lifestyle and treatment strategies. Regular check-ups with a cardiologist are particularly important now.

What women can do for their heart: Prevention tips from a specialist

The good news is: 80% of all cardiovascular diseases are preventable through a healthy lifestyle. Every woman can take action to protect her heart.

1. Know your numbers: Have your blood pressure, blood sugar and cholesterol levels checked regularly. What is an acceptable value for a man may already be a risk for you.
2. Exercise regularly: A combination of endurance sports (e.g. walking, cycling, swimming) and moderate strength training is ideal.
3. Eat a heart-healthy diet: The Mediterranean diet with lots of vegetables, fruit, whole grain products, healthy fats (olive oil, nuts) and fish is ideal.
4. Stop smoking: Smoking is even more harmful to women's hearts than to men's hearts. There is no more important single measure.
5. Take care of your mental health: Learn stress reduction techniques that suit you (e.g. yoga, meditation, time in nature).

Frequently asked questions from women about heart health

Here we answer frequently asked questions from patients in our practice.

I had high blood pressure during my pregnancy. Should I be worried?

You don't have to worry acutely, but you should be vigilant. Pregnancy-induced hypertension (pre-eclampsia) is now considered an important risk factor for the later development of chronic high blood pressure and heart disease. We recommend that affected women undergo regular cardiological check-ups, even if their blood pressure initially returns to normal after pregnancy.

How does the pill affect my heart risk?

Modern contraceptive pills are generally very safe. In women with additional risk factors such as smoking, obesity, high blood pressure or a family history of thrombosis, combined oestrogen-progestogen preparations can slightly increase the risk of blood clots. Individual advice weighing up all the risks is crucial here.

Does hormone replacement therapy during the menopause protect me from heart disease?

This question is the subject of controversial scientific debate. It used to be thought so, but large studies have shown that hormone replacement therapy does not generally reduce the heart risk and can even increase it if started late. The decision for or against such therapy must be made on an individual basis after careful consideration of the risks and benefits (e.g. for the treatment of severe menopausal symptoms) and is not a primary measure for heart prevention.

My cholesterol has risen after the menopause. Is that normal?

Yes, this is a very common phenomenon. The drop in oestrogen levels leads to an increase in „bad“ LDL cholesterol and often also to a drop in „good“ HDL cholesterol. It is therefore particularly important to monitor blood lipid levels more closely and adjust your lifestyle or, if necessary, take medication after the menopause.

Is „broken heart syndrome“ a real heart disease?

Yes, „broken heart syndrome“ (stress cardiomyopathy or Takotsubo cardiomyopathy) is an acute, stress-related dysfunction of the heart muscle that almost exclusively affects women after extremely emotionally stressful events. The symptoms are similar to a heart attack, but the coronary arteries are unremarkable. The disease usually heals completely, but requires acute medical treatment.

I suffer from rheumatism. Do I need to take special care of my heart?

Absolutely. Chronic inflammatory diseases such as rheumatoid arthritis are an independent and significant risk factor for cardiovascular disease. The chronic inflammation in the body also attacks the blood vessels. Patients with rheumatism should undergo particularly rigorous cardiac screening.

As a woman, how often should I go for cardiac screening?

An initial orientation examination is useful for every woman in order to know the baseline values. Regular check-ups should be carried out every 2-3 years, at the latest at the start of the menopause or if risk factors are present. Your cardiologist will determine a suitable interval for you.

Is an exercise ECG just as meaningful for women as for men?

Unfortunately, a stress ECG is far less accurate in women than in men. So-called „false-positive“ findings, i.e. ECG changes, occur more frequently even though the coronary arteries are healthy. Conversely, around half of heart diseases are overlooked. An experienced cardiologist knows this and will always evaluate the findings in the context of the symptoms and recommend further diagnostics, such as a coronary CT scan, if the results are unclear.

Why is sport so important for women's hearts?

Regular exercise not only helps women to control the classic risk factors, but also strengthens bones (osteoporosis prevention) and has a hugely positive impact on mental health and stress management. The positive effects are at least as pronounced in women as in men.

My doctor doesn't take my complaints seriously. What should I do?

If you feel that your symptoms are not being taken seriously or are being dismissed as purely psychological, get a second opinion. You are the expert on your own body. A cardiologist with an awareness of the subject Heart women will carefully clarify your complaints.

Take your heart health into your own hands

The health of your heart is your most valuable asset. As a woman, you have specific risks, but also great opportunities through prevention. Be attentive to your body's signals, know your numbers and don't hesitate to seek medical advice. At our practice, you will find a competent partner who understands the specifics of women's heart health and will accompany you on your journey.