‘Women Are Not Small Men’

The casket lies in state during memorial services for pop star Michael Jackson in Los Angeles July 7, 2009.
The perceived notion that heart disease is only a concern for men is wrong. Young women are having heart attacks and the incidence of heart disease in women is rising.

Cardiologist Dr. Nieca Goldberg and her patient, Susan Cuba, who had a heart attack two years ago at 43, discuss with The Early Show the serious nature of women's heart disease.

The statistics of women with heart disease are startling. Though fewer than 10 percent of women believe they are at risk for heart disease, the truth is, it is the leading cause of death in women over the age of 35.

Dr. Goldberg, of the Women's Heart Program at Lenox Hill Hospital, explains that heart disease diagnosis and prevention are important and should not be overlooked by young women. She recently wrote a book, "Women are not Small Men," which talks about the subject in length.

When Dr. Goldberg went to medical school, she learned that the typical patient with a heart attack is a middle-aged man. But as she started working as a doctor, she noticed more women were having heart attacks.

Susan Cuba thought her mild heart attack was a stomachache. After ignoring the pain, even taking a Rolaid, Susan eventually saw Dr. Goldberg in a hospital.

Susan had a family history of early heart disease. She also had a past history of smoking — though she wasn't a smoker at the time of her heart attack — and a special condition that is seen less often, antibodies that create blood clots.


The perception by women, according to a poll by the American Heart Association of 1004 women:

  • Fewer than 10 percent of women believe they are at risk for heart disease.
  • 62 percent believe cancer is the bigger health threat
  • Women aged 25-34 don't consider heart disease a big problem.

Dr. Goldberg says 25 to 30 percent of her patients had their symptoms of a bad heart condition ignored by other doctors. .

Dr. Goldberg recommends that women know their family history. If a person's father at age 50 or younger (mother at 60 year old or younger) had heart attack, stroke or symptoms of blocked arteries, that person's risk increases to 25 to 50 percent.

Everyone knows smoking is bad, but in young woman, it is very risky. Smoking triples a woman's risk for heart attacks, causing the arteries to clamp down or spasm, decreasing blood supply to heart muscle, which can cause heart attacks. Also, smoking impacts cholesterol levels, amplifying problems.

Women with poly-cystic ovary syndrome, about 20 percent of women in their reproductive years, can indicate risk for heart disease because this condition is associated with so many other risk factors.

Dr. Goldberg says oral contraceptives do not cause heart attacks but, combined with other risk factors, can increase the risk of heart attack. Oral contraceptives also can increase cholesterol.

Experts say symptoms should not be ignored. An easy way for women to self-diagnosis is for a woman to notice where how she gains weight - in an apple or a pear shape. Apples are more likely to have heart disease. Body shape is related to a carbohydrate intolerance and high blood pressure.

Classic signs of a heart attack, for men and women are:

  • Pressure, fullness, squeezing pain in chest spreading to neck, shoulder or jaw
  • Chest pain with dizziness, fainting, sweating, nausea or shortness of breath

But women can have symptoms that can be misdiagnosed because they are atypical, such as: Unusual fatigue, a new and unusual shortness of breath, nausea or dizziness not necessarily connected with chest pain, lower chest discomfort, back pain and stomach pressure, pain or discomfort.

Additionally, women must consider the role of stress. Combining work with taking care of a family can lead to increased blood pressure. Doctors recommend that women lower their stress, get family support, and be physically active.

Woman should see a cardiologist if they:

  • Have had a heart attack
  • Have symptoms of heart disease
  • Have a family history of heart attack, stroke or sudden death
  • Have high cholesterol or blood pressure
  • Need cardiac procedure
  • Have arrhythmia or heart murmur

Experts have also warned that women of African ancestry have a higher rate of diabetes, high blood pressure and obesity, all strong risk factors for heart disease. Studies also show that black women are:

  • 28 percent more likely to die of a heart attack than white women
  • 78 percent more likely to die of a stroke than white women
  • 69 percent more likely to die from heart disease between 35-74 than white women

For Hispanic women, more than 50 percent are overweight and sedentary and 17percent have cholesterol levels above normal.