Subtle signs of heart problems in women

Avid runner Michelle Sayegh is the picture of health. She stays in shape and eats well. But at the beginning of last year, she started feeling "off." 

“I started getting tired and feeling out of breath easily, which is unusual for me,” Sayegh explained.

Then one day, while out with her daughter, she got a sudden pain in her chest that ran up her back and into her jaw.

“I couldn't move for, like, I don't know, 15 minutes,” she recalled.

After it happened a second and third time, she went to the hospital. Initial testing showed nothing of concern, but after she met with a cardiologist, Sayegh discovered she was had microvascular angina.

“Heart disease in men occurs more often because of blockages in the large blood vessels which supply the heart muscle. In women, there are also the tiny blood vessels that supply the heart muscle that is affected."

Cardiologist Dr. Kashmira Bhadha says this type of microvascular disease has more subtle warning signs than many might expect.

“In women, sometimes the symptoms of a heart attack might just be that they are breathless, they have unexplained fatigue and feel weak, they feel extremely weak and can’t figure out why for no particular reason.”

The symptoms can come with emotional stress, not just physical activity, which is why every woman after the age of 20 should be evaluated for risk factors.  As a result of her diagnosis, Sayegh is on medications to reduce the risk of having another episode. 

“Having a doctor tell you what’s wrong and knowing what's wrong makes you feel a little bit better because it's not an unknown anymore,” Sayegh said.

Postmenopausal women are at higher risk for heart disease, in part because of changes in hormone levels with age. But studies have shown hormone replacement therapy for heart health is not beneficial. In fact, it increases the risk of stroke and breast cancer.