2023-05-03 16:48:38
“In France, 200 women die every day from heart disease against only 33 from breast cancer and 2 from a road accident”, worries Doctor Claire Mounier-Véhier, cardiologist and co-founder of the association. Acting for the hearts of women.
We know that the risk of heart attack increases after menopause, but we are now seeing an increasing number of young women affected: 30% of victims of myocardial infarction under the age of 55 are women.
The main explanation is found in the multiplication among women of what we call minoca. This term that sounds like an idyllic vacation destination is nothing but a form of heart attack. This one has for particularism not to be the consequence of the obstruction or the coronary stenosis.
“Minoca (abbreviation for “myocardial infarction with non-obstructive coronary arteries”) can be explained by the erosion of the non-obstructive atheromatous plaque but also by spasms and coronary dissections. They occur outside of any coronary disease. risk factors such as heredity, smoking or stress are most often involved “, according to the specialist.
Heart attack in women: risk factors at all ages
At the same age, women have more risk factors than men, with thinner and more fragile arteries. They are also subject to specific risk situations during the three key phases of their hormonal life: contraception, pregnancy and menopause.
“A heart attack is always explained by a known or long unsuspected risk factor”, according to the expert. Certain factors expose the woman even before 50 years as:
- heredity : “this is particularly the case of infarction linked to coronary dissection which can often be anticipated thanks to the existence of a family history known to the patient”.
- The stress : “it is more present in precarious environments where heart attacks are more frequent. In addition, women tend to suffer a greater mental load than men on average”, notes the cardiologist.
- Tobacco, cannabis and the use of certain narcotics (such as amphetamines): they are responsible for vasoconstriction and promote coronary spasms.
- Pre-eclampsia and gestational diabetes in pregnant women: these pathologies are risk factors for future cardiovascular disorders.
- Certain pathologies with cardiovascular risk: vein thrombosis, headaches and migraines, systemic lupus erythematosus (SLE)…
- Chest radiotherapy : “women who have had breast cancer have an increased cardiac risk due to radiotherapy”.
Note that taking hormonal contraception in a woman (even at a young age) who presents cardiovascular risks is not trivial. It is appropriate for the gynecologist to take into account the personal and family history, the hygiene of life as well as a blood test (dosage of cholesterol, triglycerides and glycemia) of the patient before prescribing this type of medication.
After menopause, women must be extra vigilant about their cardiovascular health, especially in the presence of certain risk factors such as:
- high blood pressure ;
- hyperlipidemia (cholesterol and triglycerides) ;
- overweight (overweight et obesity especially visceral);
- the diabetes.
Heart attack: different symptoms in women
It’s a growing idea that the signs of a heart attack are different in men and women. The latter would present often overlooked warning signs such as migraines, fatigue on exertion, a feeling of heaviness in the arm, pain in the chest…
“These prodromal signs should not be taken lightly and should lead to consultation. In the vast majority of cases of heart attack, women show warning signs long before this incident”, underlines the practitioner.
As for the clinical picture of the heart attack itself, it is described as “atypical” in women. In particular, we observe:
- discomfort or impression of tightness in the hollow of the chest (atypical angina);
- a heaviness in the arm ;
- of the cold sweat ;
- a great fatigue ;
- of the digestive disorders (stomach painsof the nausea or some vomiting).
“The infarction can give rise to digestive disorders such as nausea and gastric pain because the heart is close to the esophagus and the stomach (in particular its floor and its right part) with common innervations.”
Often delayed diagnosis and treatment
“Generally, signs of heart attack always worry more when they appear in a man than in a woman”, observes the expert. A woman who has a heart attack will be taken care of on average 1 hour later than a man. No doubt, because this condition is more common in men or because we cling to the idea that female hormones protect against cardiovascular accidents.This is true before menopause.Nevertheless, the combination of the pill and tobacco increases the risk of myocardial infarction.
Early diagnosis allows patients to receive appropriate treatment as soon as possible, in order to avoid immediate complications after the infarction (such as death) or future sequelae.
“Furthermore, it has been shown that after a heart attack, women are less well followed than men. For example, conventional treatment combining beta-blockers, statins, and aspirin is much less prescribed to women than to men after a heart attack. This is especially true when the infarction is not explained by a coronary obstruction”, according to Doctor Claire Mounier-Véhier. Here again, receiving these drugs makes it possible to avoid complications and to limit the risks of recidivism.
Myocardial infarction in women: how to prevent it?
As in men, myocardial infarction in women can be prevented by optimizing lifestyle:
- a healthy and balanced diet;
- normal weight (BMI between 18.5 and 25);
- regular physical activity;
- smoking cessation;
- avoidance of stressors.
“Stress is a major risk factor. Especially since after a heart attack, women go much less often than men to rehabilitation, while this care allows them to learn how to manage stress”, deplores Professor Claire Mounier – Vehier.
On the other hand, it is advisable to consult a doctor in the event of frequent migraines or other evocative signs such as fatigue on exertion or recurrent chest pain. Women who have cardiovascular risk factors must imperatively maintain regular medical follow-up. For their part, patients who have experienced a heart attack must access a cardiac rehabilitation program adapted, in hospital or on an outpatient basis, and regularly consult their general practitioner (every 3 months) and their cardiologist at least once a year.
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