Heart disease in women: Not always the same as men

Cardiovascular disease remains the leading cause of death for women although many women believe that they are more likely to die from breast cancer. Women have cardiac events on average 10-12 years later than men with rates rising after the menopause.  

Women have many unique risk factors for cardiovascular disease including adverse pregnancy outcomes particularly preeclampsia and gynaecological conditions including polycystic ovaries and endometriosis. Inflammatory arthritis particularly rheumatoid arthritis occur more commonly in women and are also associated with increased risk.

Breast cancer treatments carry cardiac risk. Radiotherapy increases rates of coronary, valvular and aortic diseases and arrythmias. Cardiomyopathies are associated with Adriamycin chemotherapy and Herceptin.  

Atypical coronary events including Spontaneous Coronary Artery Dissection (SCAD), coronary artery spasm and Takotsubo Cardiomyopathy occur more commonly in women. Women, particularly younger women, often have atypical presentations with coronary disease and are less likely to be referred for care.  

Our challenge is to recognise women in our practices at risk of cardiac disease, provide appropriate preventative treatments, ensure that they receive timely care for cardiac events. Women are at the heart of the family. We need to support them to remain there.