THE WOMAN’S HEART                                                                         

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Dr. Marco de Vaan, your cardiologist at the Costa Blanca in Clinica La Ermita. TEL. (+34) 625 552 656 www.heartclinic.es Mail: NL: BIG/RGS registration 89024389601


THE WOMAN’S HEART, Cardiologist Marco de Vaan explains Marco de Vaan is a highly qualified cardiologist with 30 years of experience and founder of the Heart Clinic, an independent outpatient clinic with consultation hours in Javea and Moraira.

In the coming months, Marco de Vaan will elaborate on some topics in cardiology in more detail. Today’s topics is the Women’s Heart, a subject that is increasingly attracting attention. Men and women are biologically different, therefore women experience symptoms differently than men also they express themselves distinctly from men ánd their complaints may be different.


Why does the female heart deserve more attention? Heart disease is common in women. Every year more women die of cardiovascular disease than of breast cancer. Cardiovascular disease is the number one cause of death in women worldwide. The symptoms of heart disease in women are still under-recognised because they differ from those of men. As a result, they are diagnosed later. Complaints are sometimes associated with hormonal problems. In addition, women sometimes visit a doctor too late.


Women do not always quickly associate their complaints with their heart. Especially if the complaints are vague (not typical). I notice that women, when they come with complaints, they already give an explanation for it. For example for increasing fatigue ” but it was a busy time”. Palpitations: “it must be the menopause”. Because ‘chest pain’ as a manifestation of cardiovascular disease in women is often absent or only remotely present, women attribute their symptoms to overtiredness or getting older. While men go to the GP because they have a cramping or oppressive chest pain, women come with complaints such as fatigue, dizziness, nausea, shortness of breath and back pain. Heart complaints in women can be atypical compared to most heart complaints in men. However, these symptoms are typical for women. Heart complaints in women often start with an erratic pattern of pain between the shoulder blades, a feeling ‘like the bra is too tight’. These symptoms do not resemble the classic pain, which is described as if an elephant is sitting on the chest, and radiating to the jaw or left arm. As a result, women can suffer a heart attack without knowing it themselves, and thus face serious health risks.


Is the Women’s Heart different? Generally speaking, no. What does differ, is that the coronary arteries in women are laid out somewhat finer and smaller. The inner lining of these vessels is more sensitive to hormones and stress. The constrictions are less often in isolated places, but are more diffuse and over longer stretches. The coronary arteries are also more likely to spasm (sudden contraction of the vessel wall) with consequently sudden complaints of oxygen deprivation in the heart muscle. An unpleasant squeezing sensation is usually the result. This can occur suddenly with no relation to exertion and we call this an atypical complaint, but one that must be approached seriously. In women, risk factors for cardiovascular disease such as high blood pressure are quite often wrongly attributed to stress or menopause. For example, if a woman has had high blood pressure during pregnancy, then this may already be a precursor for developing cardiovascular disease later in life: the risk is 2-5 times higher. Cardiovascular disease occurs on average 10 – 15 years later than in men. This is because women are protected by female hormones (oestrogens). After the menopause, women produce less oestrogens, and the risk of cardiovascular disease increases. This is also the case in women who enter menopause early (younger than 35-40 years). There are also women with naturally lowered oestrogen levels. Then there is reduced protection and thus an increased risk. Finally, there are women who develop heart disease at a much younger age, independent of oestrogens. Women often need to be able to do everything at once and perfectly as well. This causes increased stress, which leads to high blood pressure, which in turn is a risk factor for cardiovascular disease. Smoking, an unhealthy diet and lack of exercise play an important role.


Apart from the differences in complaints, there are also differences in treatment Vascular disease of the heart is not always treated with the same drugs. Since in women vascular disease can spread more diffusely throughout the coronary arteries, a different approach is needed. Then you mainly use medications that have vasodilatory effects. The choice of medication depends very much on the severity of the symptoms, and the risk factors present. It is very important to take enough time for the consultation, listen carefully and identify all risk factors. So that all patients, including those with vague or atypical complaints, get the attention and treatment they need. Especially when coronary artery disease is suspected, potentially important differences between the female and male heart must be taken into account.


Heart Clinic has set up a special consultation hour for women who experience complaints that could possibly originate from the heart and for women with an increased risk of cardiovascular disease. You can visit us quickly, often within a few days. Don’t hesitate to contact us, we are there to advise you.