Women Struggling to Recognize Heart Disease

Heart disease is the leading cause of death in women in the United States, with some statics showing it kills as many as 1 in 5 women. Despite these scary numbers, only about ½ of women recognize heart disease as the number one killer. Heart disease is 16x more frequent in women than breast cancer. Women must learn to recognize the symptoms of heart disease and act quickly. Nurses General Nursing Knowledge

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Women Struggling to Recognize Heart Disease

Her alarm goes off, and it's another morning of struggling to get out of bed.  After peeling herself out of bed, she shuffles to the bathroom and notices her feet seem even more swollen today than usual.  She thinks, "I need to cut back and eat healthier.”  Later she is whizzing around the kitchen, making breakfast, pouring coffee, and getting ready to head out the door, and wow, her indigestion is bothering her this morning.  She feels so full, and these hot flashes are killing her. She is sweating now, and her jaw is aching; she must have ground her teeth again last night in her sleep. Suddenly, she is so exhausted. Her partner comes in and sees her. "You don't look so good. Are you OK?” "I'm fine. I need a little rest. The weekend can't come soon enough.”  Later that morning, while at work, she passes out, and her co-workers call 911.  She is transported to the nearest hospital, admitted, and diagnosed with heart disease.

These days, women are juggling their schedule between keeping up with children's activities, their partner's activities, and, oh, let's squeeze a career there. As a result, self-care keeps getting further pushed down on the "to do" list.  "I just need a good night's sleep" or "I'll rest after XYZ is done" are a few common themes. Unfortunately, this constant struggle of go, go often leads to women ignoring or dismissing vital signs and symptoms of heart disease. Couple this with the fact that many women with heart disease sometimes have vague, dangerous symptoms.

Heart disease is the leading cause of death in women in the United States, with some statics showing it kills as many as 1 in 5 women. Despite these scary numbers, only about ½ of women recognize heart disease as the number one killer. Heart disease is 16x more frequent in women than breast cancer. In fact, in recent years, the death rate from heart disease has gone down in men but has slightly increased in women.  The rise in the prevalence of diabetes has also contributed to the increase in heart disease in women. Diabetes can not only be a contributing factor to heart disease in women but also further complicate and worsen symptoms of heart disease in women.

Risk Factors

There are many risk factors for heart disease in women, so women need to be aware of these risk factors. Women need to take an active role in decreasing their risk factors. Risk factors for heart disease in women include:

  • Diabetes
  • Smoking
  • Decrease physical activity
  • Emotional stress and depression
  • Menopause
  • Pregnancy complications
  • Family history
  • Inflammatory diseases such as Lupus and Rheumatoid arthritis

Some women can have a genetic predisposition to heart disease, but many of these risk factors can be decreased with better daily life choices. For example, smoking is a huge risk factor that can be eliminated by quitting. Many hospitals and physicians' offices have programs and counselors that help persons quit smoking. Tight control of blood sugars and healthy food choices are other factors that women can control to decrease their heart disease risk. Small diet changes over time can have a significant impact on lowering HGB A1C levels (blood tests used to determine blood glucose levels).  Daily meditations, physical activity, and scheduled "time outs" for a bit of peace and quiet can decrease emotional stress. Regular check-ups with your primary physician, including yearly labs to check cholesterol, HGB A1C, thyroid function, and stress hormones, can help mitigate risk factors and identify them early.


Symptoms of heart disease or a heart attack can be different in women than in men. These differences can result in women often ignoring or dismissing these symptoms. Symptoms of heart disease can occur about ten years later in women than men in part due to the drop in estrogen after menopause.  Symptoms of heart disease in women can be:

  • Neck or jaw pain or aching
  • Shoulder or upper back pain
  • Arm pain in one or both arms
  • Sweating
  • Dizziness or lightheadedness
  • Suddenly feel tired or weak
  • Indigestion or nausea
  • Pain or pressure in the chest
  • Feeling full or aching in the upper abdomen

Women often overlook these symptoms or try to explain them as something else. "I am just feeling tired today,”; "it's just been a long week,”; or "I ate something that doesn't agree with me" are just a few of the common reasons women will come up with to try to explain these symptoms.  Women, especially post-menopausal women, need to educate themselves on the symptoms of heart disease and monitor themselves regularly.  Sometimes heart disease in women can present as general fatigue and shortness of breath.  They can have swelling in their legs or abdomen.  They can have persistent indigestion or nausea that is not relieved by medications.  Women often complain of pain or aching in their jaw and arm or armpit.  They can have feelings of fullness in their upper abdomen or pressure in their back or lower chest.  Women can feel sweaty and think they are having a hot flash.

Women need to be an advocate for their health. Women with heart disease are often overlooked or misdiagnosed when they first go to the doctor. Heart disease in women has often been misdiagnosed as thyroid disease, depression, or menopausal symptoms. A woman may also have this diagnosis as well as heart disease. Women need to make sure their practitioners are listening to their symptoms and if women need to make sure they are being heard.  An ECG is an easy, non-invasive test that physicians can order that provides a clear electrical picture of the heart.  Women should not be afraid to ask for an ECG if they feel their symptoms may be related to heart disease.  Women need to keep speaking up until they find answers.


Heart disease in women: Understand symptoms and risk factors

Lower Your Risk for the Number 1 Killer of Women

Women & Cardiovascular Disease

Heart disease in women: Unsuspected? Overlooked? Ignored?

My name is Stacy Phillips, RN, BSN, CWCN, and I have been a nurse for over 20 years in critical care, wound care, and case management. I have a passion for educating patients and health care workers on living their best, healthy life.

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nursej22, MSN, RN

3,623 Posts

Specializes in Public Health, TB.

Thank you for this article. As a woman with a strong family history and a current heart condition, I can confirm that this is important information

Two comments:

I am not sure that yearly A1C, thyroid, lipid, or stress hormone level checks are indicated for every woman, and can be rather expensive. Certainly it is an important topic for discussion with your provider. 

Secondly, not heart disease is related to coronary artery disease. Arrhythmias and valve disease is something to be aware of, and may occur concurrently or separately from CAD. 

Stacy Phillips, BSN, RN

2 Articles; 4 Posts

Specializes in RN, BSN, CWCN.

Thank you so much for your feedback. I appreciate both of your comments. Hopefully, women like you and me can continue to bring awareness to this critical topic. 

Maggie Aime, BSN, RN

3 Articles; 12 Posts

Specializes in Freelance Writer, Utilization Review RN Consultant.

Thank you for raising awareness on this very important issue!  There's also the misconception that heart attack is a man's disease.  Well done. 


3 Posts

Great article, thank you for the effort to raise awareness on this critical issue.

Stacy Phillips, BSN, RN

2 Articles; 4 Posts

Specializes in RN, BSN, CWCN.

Thank you so much.  I appreciate your feedback. 


Julita, BSN, RN

3 Articles; 11 Posts

Specializes in Freelance Health Writer.

So informative article. Thank you for sharing.

Jenni Binford

1 Article; 10 Posts

Specializes in Med/surg, oncology, telemetry staff RN.

This is great information, thanks for writing!

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