Medically Reviewed by Suzanne R. Steinbaum, DO on February 04, 2020

The Same but Different

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Heart disease is the most common serious health issue among both men and women in the U.S., but it doesn't affect them the same way. Some heart conditions are more likely to happen in women, and symptoms of others can be different for the two genders. It’s important to know what to watch for and how to protect yourself as you get older.

Warning Signs

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In the movies, everyone has chest pain during a heart attack. In real life, women may have less obvious symptoms and are as likely to have shortness of breath as chest pain. You also might feel pain in your jaw, back, or upper belly. And women also may feel nauseous, lightheaded, or dizzy.


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Spontaneous coronary artery dissection (SCAD) is when one of your heart’s blood vessels tears. That can slow down or block your blood flow and lead to intense chest pain and other symptoms that can feel like a heart attack. This is a serious condition that needs to be treated quickly. Women are more likely than men to have SCAD, especially if they’ve given birth recently.

‘Broken Heart’ Syndrome

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The medical term for this is stress-induced cardiomyopathy, and it's more likely to happen to women than men. It’s caused by a sudden release of stress hormones, and it happens after very emotional events like divorce or a death in your family. A part of your heart gets bigger and can’t pump blood as well. That can cause intense chest pain, but quick treatment can lead to a full recovery.


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While they don’t cause heart disease, the natural changes that happen to your body during menopause can make you more likely to have it. As your levels of estrogen go down, your arteries can get stiffer. And your blood pressure, belly fat, and LDL (or “bad” cholesterol) can go up after menopause, too. Stay active to help keep your heart healthy after “the change.”


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If you have a condition that causes this, like rheumatoid arthritis or lupus, your chances of heart disease are higher. That’s true even if you’re young, exercise, and don’t smoke. Keep your inflammation in check with medications -- but try to stay away from steroids, which can raise your odds of heart disease. Talk with your doctor about the best way to protect your heart.


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This mental health condition can double your chances of heart disease, and women are twice as likely to have it as men. It can make you less likely to stay active and take care of your health, and ongoing stress and anxiety can put a strain on your heart. Talk with your doctor or a therapist if you think you might need help for depression.


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This condition also can double a woman’s chances of heart disease. One reason is that high blood sugar slows down the flow of oxygen in your blood and can lead to plaque buildup in your arteries. Another is that women with diabetes may be more likely to be obese and have high blood pressure and high cholesterol. You can manage your weight and blood sugar levels with diet and exercise.

Thin Women Can Get Heart Disease

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Heavy women are more likely to have multiple risk factors and therefore more likely to be at risk for heart disease. But being slender doesn’t mean you can’t get it. Women who are slim can still have high cholesterol, high blood pressure, and smoke, and those are just three of the things that can raise your odds of having a heart condition. Being aware of your risks and then doing something about them is important regardless of your weight. Your doctor can help you discover your risks and learn ways to deal with them.

Prevention: Check Your Family Tree

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If your mom or sister had heart disease before age 65, or if your mom had a stroke at any age, you can be more likely to have heart disease. That doesn’t mean you’ll have a heart attack or stroke, but make sure your doctor knows your family history. They can help you take the right steps to lower your chances.

Prevention: Quit Smoking

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Women who smoke are 25% more likely to have heart attacks than men who do. It damages blood vessels, raises your blood pressure, and can lead to blood clots. Your chances are even higher if you take birth control pills and smoke, especially after 35.

Prevention: Watch Your Cholesterol

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This soft, fatty stuff can build up in your arteries and lead to plaque that hardens over time and clogs your arteries. A quick blood test can tell you and your doctor your numbers. To lower your “bad cholesterol” (LDL), focus on simple changes. Keep an eye on the amount of fat and sugar in your diet, get more exercise, and watch those cocktails.

Prevention: Stay a Healthy Weight

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Eat more fresh, whole foods, especially ones that are low in calories, sodium, and trans fats. Check out heart-healthy cooking classes or online videos. And find fun activities that get you off the couch: Walk with your friends, take a Zumba class, or go salsa dancing.

Prevention: Fitness Matters More After 40

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Even if you’ve never been a workout queen, take steps to boost your fitness as you hit 40. Women in middle age can cut their chances of some heart conditions with regular exercise. Small changes to your routine can make a big difference.

Pregnancy Heart Protection

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When you’re pregnant, your heart pumps more blood. This can put stress on your heart and arteries. Labor and delivery add to the strain. Women who have heart rhythm or valve issues should watch for shortness of breath, a fast heart rate, or signs of serious infections while they’re pregnant. If you have high blood pressure or get it during pregnancy, it could lead to a serious disorder called preeclampsia that can cause health problems for both mother and baby.

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American Heart Journal: “Rheumatoid Arthritis and Cardiovascular Disease.”

Expert Reviews in Clinical Immunology: “Systemic lupus erythematosus and cardiovascular disease: prediction and potential for therapeutic intervention.”

National Coalition for Women With Heart Disease: “Women, depression, and heart disease,” “Spontaneous Coronary Artery Dissection (SCAD).”

Mayo Clinic: “Depression (major depressive disorder),” “Depression and anxiety: exercise eases symptoms,” “Heart conditions and pregnancy: know the risks,” “High blood pressure and pregnancy: know the facts,”

American Heart Association: “Is Broken Heart Syndrome Real?” “Menopause and Heart Disease,” “Simple Cooking With Heart Kitchen,” “Common Myths About Heart Disease,” “Smoking and Heart Disease.”

Johns Hopkins Heart and Vascular Center: “Diabetes and Heart Disease in Women.”

National Heart, Lung, and Blood Institute: “Who Is at Risk for Heart Disease?”

Georgia Department of Public Health Coastal Health Division: “Make Physical Activity Fun.”