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Heart failure risk in women

by Pierre Koenig

If the pumping power of the heart decreases, this has consequences for the entire body. Organs such as the brain, liver, kidneys and muscles are no longer supplied with enough oxygen and nutrient-rich blood. Cardiologists distinguish between different forms of cardiac insufficiency (medical heart failure). In the case of cardiac insufficiency with reduced pumping function (systolic heart failure), the heart no longer pumps powerfully enough. In the case of cardiac insufficiency with a preserved pumping function, the heart still pumps vigorously, but it no longer fills up with enough blood because the tissue is no longer elastic enough. Cardiologists then speak of diastolic heart failure.

Heart failure in women: the elasticity of the heart is often disturbed

“Women are more likely to suffer from diastolic heart failure, i.e. a disturbance in the elasticity and thus in the filling of the heart,” says cardiologist Prof. Dr. Christiane Tiefenbacher, board member of the German Heart Foundation. This is due to the differences between male and female hearts in both size and pumping capacity. This is reflected in the form of heart failure. Because women generally have a slightly stiffer and smaller heart than men. It is less able to stretch and fill with blood. This is compensated for by a higher pump capacity. As women get older, this anatomical fact becomes more important: the size of the heart decreases with age. During menopause, the reduced production of estrogen leads not only to an increase in blood pressure but also to an increased formation of connective tissue in the heart. The heart continues to lose elasticity.

Other risk factors that favor heart failure in women

And there are other influencing factors that promote cardiac insufficiency in women: “High blood pressure, obesity and diabetes mellitus in particular have a negative effect on the elasticity of the heart tissue and are therefore important risk factors for cardiac insufficiency for women. If they occur together, their effects are potentiated,” explains the chief physician for cardiology at the Marien-Hospital Wesel. The factors mentioned are also critical with regard to the risk of a heart attack. “Heart failure is often the result of a heart attack. When the heart has an infarction, heart tissue dies and scarring occurs, which limits the heart’s performance,” says the Heart Foundation expert.

Recognize symptoms of a weak heart

Heart failure usually develops gradually – and therefore often remains undetected for a long time. It is not uncommon for the symptoms to be mistakenly dismissed as signs of aging. “Women should be vigilant. Shortness of breath, reduced performance and exhaustion are the first symptoms of cardiac insufficiency. Water retention, so-called edema, also often causes the feet to swell,” says Prof. Tiefenbacher. Everyday activities become more strenuous, such as climbing stairs, shopping or cycling.
Important to know: A sudden onset of symptoms such as shortness of breath, tiredness, physical weakness, sleep disorders or occasional back and upper abdominal pain can indicate a heart attack in women. The typical chest pain is often absent or less pronounced. Information on heart attack symptoms: https://herzstiftung.de/herzinfarkt-frauen-symptome

What makes heart failure so dangerous

Heart failure is a serious and insidious disease that usually manifests itself with unspectacular symptoms and gradually with shortness of breath, reduced performance and fluid retention, for example in the lower legs (swollen legs, ankle edema). This harbors the risk that older sufferers will attribute their symptoms to their age and simply accept them instead of going to the doctor.

Chronic heart failure should always be treated. In this country, heart failure is one of the most common causes of death and is a more common cause of death than cancer. Up to four million people in Germany have a weak heart. The risk increases with age. More than 40,000 people die from this disease every year. “Anyone who suffers from shortness of breath should have a doctor clarify whether a heart disease, such as cardiac insufficiency, is the cause,” advises Prof. Tiefenbacher. “The earlier a diseased heart is recognized and treated, the easier it is to counteract a deterioration.”

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The guide “Coronary heart disease and heart failure – what is different in women?”
(20 pages) can be ordered free of charge from the Heart Foundation on telephone (0 69) 955128-400 and under http://www.herzstiftung.de/bestellung be requested.

Podcast: imPULS – knowledge for your health
Women’s hearts hurt differently – A podcast talk about the small difference in the heart with expert Prof. Vera Regitz-Zagrosek: http://www.herzstiftung.de/podcasts