Why chest pain in women is different and shouldn’t be dismissed

Chest pain in women can be the result of coronary microvascular disease — a condition in the smaller arteries that branch from coronary arteries.

Chest pain in women is often different from men’s typical experiences. Also known as angina, heart-related chest pain is the result of a decrease in blood flow to the heart.

It can be difficult to know the difference between angina and other causes of chest pain. Other than heart disease, stomach and esophagus issues, lung issues and muscular pains are potential causes of chest pain. If you aren’t sure, always seek medical attention — emergency rooms in the Louisville area are fully staffed and supplied with personal protective equipment. Special protocols are in place to make patients, staff and the community safer and limit the spread of the coronavirus.

Some heart attacks are intense and very quick, while others start slowly with mild pain or aches.

“Tightness and pressure in the chest are common symptoms of angina,” said Mostafa O. El-Refai, M.D., M.S., MBA, interventional cardiologist with Norton Heart & Vascular Institute. “But chest pain in women, and others, also may be accompanied by feeling out of breath, nausea, vomiting, abdominal pain or a sharper pain in the chest. Sometimes the sign of an underlying heart issue is difficulty breathing without any pain at all.”

These additional symptoms can mislead patients into dismissing their chest pain as part of something else.

“Your body speaks to you — if you have any new symptoms you should have them evaluated either by your primary care provider or an appropriate specialist,” Dr. El-Refai said.

Norton Heart & Vascular Institute

Norton Heart & Vascular Institute specialists treat more people for heart and vascular care — about 250,000 every year — than any other provider in Louisville and Southern Indiana.

(502) 891-8300

Why chest pain in women is different

While angina can be caused by a blocked coronary artery, chest pain in women can be the result of coronary microvascular disease — a condition in the smaller arteries that branch from coronary arteries. Coronary microvascular disease tends to strike younger women who show no blockages in the larger arteries during a cardiac catheterization.

The pain is caused by damage to the inner walls of these smaller blood vessels, which decreases blood flow to the heart. In addition to being linked to gender, microvascular disease also affects men and women with diabetes, high blood pressure or inherited cardiomyopathy.

The risk factors for microvascular disease may overlap with the links to heart disease from a buildup of plaque in the arteries (atherosclerosis).

Having one or more of these risk factors increases your risk of heart attack or a form of heart disease:

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