A condition that is anything but new. For decades studies have shown that women are more likely to die of a heart attack than men. This is because women often seek help when it is too late and then medical errors are made. Why is this happening;

Professor of cardiology Christiane Tieffenbacher at the Marien Clinic in Wesel and member of the German Society of Cardiology sees it happen every now and then. A 52-year-old woman collapsed at the gate and had to be brought back up. She had been to the orthopedist with arm and chest pains and the doctor sent her home instead of the hospital. The woman had suffered another heart attack and could not interpret her symptoms correctly and neither could her doctor.

Women are more than twice as likely to die after a heart attack than men, according to a study presented at the European Society of Cardiology (ESC) conference in Prague. The study included 884 patients, a quarter of whom were women. For women, it took an average of 15 minutes longer than for men of the same age before doctors intervened to treat blocked coronary arteries. Within 30 days, nearly 12% of women had died compared to 5% of men.

However, in this study many women often had other pre-existing conditions than men. So the researchers conducted another analysis, where they separated men and women based on risk factors for cardiovascular disease, such as high blood pressure, diabetes, cholesterol and smoking. However, there were still significant differences. More than a third of women had suffered a heart attack and 11% died within 30 days compared with 3% of men.

Different symptoms in men and women

One reason this happens is because the symptoms are different in men and women. Professor Tiefenbacher says women usually experience less obvious symptoms such as shortness of breath, arm twitching, unexplained fatigue, anxiety, sweating, nausea, or vomiting and pain in the upper abdomen or back. For women the symptoms are not given the same attention as for men where the usual symptom is chest pain.

In the 1990s an American cardiologist described it as “Yentl” syndrome. The name refers to a short story by Isaac Singer, which was made into a film. In the film, a girl dresses as a man in order to be taken seriously. The cardiologist found that women experiencing heart attacks received help more quickly when they described typical male symptoms. Meanwhile, gender-related differences are increasingly being taught in medicine as well as in further education, says Professor Tiefenbacher, who is optimistic about the future. However, this is probably not enough, as studies from the US and Poland have shown that the symptoms of women with a heart attack are recognized more by a female doctor than a male one.

The other side of the problem lies with the women themselves. Older women in particular hesitate much more than men before getting help, as studies also attest. As a result, valuable time is lost in order to provide the necessary help, points out the German Center for Cardiovascular Research (DZKH), while emphasizing that cardiovascular diseases are still underestimated in women.

Leading cause of death in Germany

Heart attack is the leading cause of death for women in Germany. In 2021 specifically 18,000 women died of a heart attack. Among other things, the anatomy of women contributes to this. Professor Tiefenbacher explains that women’s hearts are built a little differently. They have less elasticity and are smaller. As women age, the size of the heart decreases and loses its elasticity.

Common symptoms of heart failure such as exhaustion and shortness of breath are considered signs of old age, which is why they go unnoticed for a long time. “The goal should be for women and men with heart disease to be treated equally well,” says Tieffenbacher. The medical community is trying to emphasize the importance of the difference between women and men in heart disease. The chairman of the board of the German Society of Cardiology launched an initiative entitled: “Women, pay more attention to your hearts!”. Tiefenbacher, on the other hand, wants more weight to be given to gender differences in medicine.