Texas Health is a proud to be the North Texas Go Red for Women® Cause sponsor, joining the American Heart Association in the nationwide movement dedicated to raising awareness, improving health and ending heart disease as the No. 1 killer of women. Texas Health is committed to inspiring and empowering women to better achieve health and well-being through education, personal action and collective impact.

Knowledge is power when it comes to recognizing the signs of a heart attack and taking steps to lower heart disease risk. The most common symptoms people associate with a heart attack are chest tightness or pressure. But for women, a lot of other symptoms may be experienced, and they can differ from those for men.

“Women, especially younger women, are less likely to recognize they are having a heart attack,” says Nina Asrani, M.D., a cardiologist on the medical staff of Texas Health Fort Worth and at Texas Health Heart and Vascular Specialists, a Texas Health Physicians Group practice. “They often attribute their symptoms to less life-threatening conditions, such as acid reflux, the flu or aging.”

The best way to prevent a heart attack is to know your risk and to be able to recognize the signs that you might be having one.

Recognizing a Heart Attack

A heart attack occurs when the blood flow to your heart muscle is severely reduced or cut off completely because your arteries are narrowed or blocked. Blood carries oxygen, which your heart needs to function properly. Without enough oxygen, the heart muscle starts to die.

Heart attacks are often caused by a buildup of plaque in the arteries, called atherosclerosis. Atherosclerosis is part of what is referred to as heart disease, which is the number one cause of death in women.

During a heart attack, women are more likely to experience any of the following symptoms:

1. An ache or pain down either arm, but especially the left arm
2. Pain in the neck, jaw or between the shoulder blades
3. Nausea/vomiting
4. Shortness of breath, dizziness, lightheadedness or fainting

Symptoms that come on suddenly may be the first signs of a heart attack. “But any of those symptoms can be concerning or worth getting checked out,” Asrani notes.

Protecting Your Heart

The American Heart Association (AHA) estimates that 80% of heart disease is preventable if we do a better job managing our risk factors. Asrani points to these traditional risk factors in assessing cardiovascular disease:

• High Blood Pressure. “You don’t necessarily feel bad when your blood pressure is high, which leads to damage to the heart over time,” she says. “That’s why it’s important to have it checked regularly.”
• Diabetes. Adults with diabetes are twice as likely to have a heart attack as people without diabetes. It also could happen at a younger age. “Knowing your fasting blood sugar can reveal diabetes, which is a big marker for heart disease,” according to Asrani.
• High Cholesterol. Blood tests can determine your good and bad cholesterol levels.  Bad cholesterol (LDL) is especially important in assessing your risk for heart disease.
• Smoking. According to the Centers for Disease Control, smoking causes roughly one in every four deaths from heart disease.
• Overweight and Obesity. Too much fat, especially in the waist area, puts you at higher risk for health problems.
• Family History. Heart health can be hereditary, so Asrani recommends getting a screening test. “If you know you have inherited a higher risk of heart disease, that empowers you to take making lifestyle changes a little more seriously than if you thought you were at a lower risk.”
• Age and Sex. Women who experience a cardiovascular-related event usually do so about 10 years later in life than men do, on average. 

The good news is there is plenty you can do to protect your heart and minimize your risk of developing heart disease. The AHA’s Life’s Essential 8™ are key measures for improving and maintaining cardiovascular health. They include:

1. Eating better. Strive for an overall healthy eating pattern that includes lots of fruits and vegetables, lean proteins, nuts and seeds, and cooking with healthy oils such as olive and canola.
2. Being more active. Aim for at least 150 minutes of moderate or 75 minutes of vigorous physical activity per week.
3. Quitting tobacco. Get help to quit if you smoke or vape and avoid secondhand smoke.
4. Getting healthy sleep Aim for an average of 7-9 hours of sleep a day.
5. Managing your weight. Reach and maintain a healthy body weight, which can be determined by calculating your body mass index (BMI).
6. Controlling your cholesterol. Get your cholesterol checked and talk to your health care provider about your numbers and how they impact your overall risk.
7. Managing your blood sugar. Keep your fasting blood sugar less than 100 mg/dL or your A1C at less than 5.7%.
8. Managing your blood pressure. Keep your blood pressure below 120/80 mm Hg.

Asrani also recommends stress management and talking to your doctor about your pregnancies and menopause. “There is evidence that early menopause can be a risk factor for heart disease, and it’s important to know your pregnancy-related risk factors — such as preeclampsia.

Barriers to Care

Since heart disease and heart attacks may present differently in women than they do in men, cardiac care has historically not been as good for women as it has for men, according to Asrani. Research has shown that women and Black people are less likely than men and white people to be referred for cardiac catheterization, a test used to evaluate coronary artery narrowing or blockage that can lead to heart attack.

Even among women, racial disparities persist. One recent study found that Black women are less likely to have ideal heart health than white women. Further studies show that Black women are more likely to have less than ideal blood pressure, blood glucose and body mass index and Hispanic women are more likely to have less than ideal blood glucose, BMI and physical activity levels.

Some of these differences are due to social determinants of health, such as where someone lives. Living in an area where the main food options are fast-food restaurants or convenience stores can make eating healthy much more difficult. And being able to be outdoors safely is essential for getting regular exercise outside, such as walking or biking.

“It is a goal of the American Heart Association to try to address some of these underlying issues in working toward more equitable health outcomes,” Asrani adds. “But if you have concerns about accessing care, ask your health care team for support with finding resources that can help.”

The AHA believes that every person deserves the opportunity for a full, healthy life. As champions for health equity, the AHA has committed to advance cardiovascular health for all by 2024, including identifying and removing barriers to health care access and quality. Learn more.

Learn more about heart and vascular services at Texas Health, or take the heart health assessment to find out your risks for heart disease.

This article was developed by the American Heart Association for Texas Health.