Heart attack in women

The heart attack was originally thought to be a typical male and manageral disease, but this has changed in recent years. According to figures from the Federal Statistical Office in 2002, more than half of the female died of heart attack. However, a study examining coronary risks for women showed that this was not due to employment. On the contrary, better educated and working women were less at risk. Why then this imbalance?

Women are particularly at risk after menopause

First, women usually get later than men, namely after menopause, a heart attack. On the other hand, they have other symptoms than men, so that women do not recognize the heart attack as such and therefore act accordingly late. Unfortunately, one confirmed thesis is that women are treated differently after a heart attack and as a result have fewer chances of survival than men with heart attacks.

In younger women before menopause, cardiovascular disease is rare-except when multiple risk factors are present. The reason for this are the hormones, more precisely the estrogens. The estrogens lower the "bad cholesterol" (LDL cholesterol) in the blood and raise the "good" HDL cholesterol. The exact protective power of estrogens has not yet been adequately explained. However, there is evidence that estrogens act directly on the cell layer that lines the blood vessels from the inside (endothelium).

The production of vasodilator chemicals (prostacyclin) is boosted and nitric oxide (NO) released more. As a result, already narrowed vessels become more permeable. However, after menopause, women lose their biological protective shield from vascular disease. The ovaries gradually stop producing estrogen, the protective effect becomes weaker, and the risk of disease triples. Therefore, cardiovascular diseases in women usually occur after the age of 50 years.

Do not underestimate symptoms!

The heart attack in women has special features compared to men, which lead to misjudgements of the dangerous situation. While in women, shortness of breath, nausea, vomiting, and upper abdominal pain are the only signs of alertness, men are more likely to experience severe tightness along with heavy pressure in the chest. Severe pain in the chest for more than five minutes, radiating into the arms, shoulder blades, neck and jaw, combined with anxiety or panic, also indicates a heart attack.

The alarm signals in men are well known, but less so in women. "It's been proven that 30% of all heart attack patients respond too late and see a doctor, and many women do not recognize the symptoms or do not want to go to the ambulance for every pull, but here's the point: call the ambulance too late rather than late, " So Professor Klör from the University of Giessen, Department of internal medicine and board member of the DGFF eV.

Serious differences in treatment

Current studies also show that women - if they come to the hospital after a heart attack - get a different therapy than men in the same case. Only a few women in Germany receive effective drugs such as beta-blockers, statins or aspirin. Also, the life-saving measure of reperfusion therapy (restoration of vascular patency, eg by balloon dilatation) or the reopening of the occluded coronary artery occurs less frequently.

The high mortality of women as a result of inadequate treatment was investigated in 2003 in the German Heart Center Munich and in the 1st Medical Clinic on the right bank of the Isar. An improvement in the chances of survival of women with heart attack by the use of currently available therapeutic measures could be realized according to this study.

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