Cardiovascular disease (CVD) remains the leading cause of premature death among Canadian women. CVD can present differently in women than in men, and important differences exist in underlying pathophysiology, risk factors, diagnosis, treatment, and outcomes. Heart disease does not always look the same in women as it does in men, and knowing that can make the difference between early recognition and a missed diagnosis.

Why Heart Disease Can Look Different in Women

Women can experience important differences across several forms of cardiovascular disease:

• Ischemic heart disease. Women may have different symptom patterns, and coronary microvascular dysfunction, coronary vasospasm, and spontaneous coronary artery dissection can contribute to ischemia or a heart attack even without obstructive coronary disease.
• Coronary artery disease. Atherosclerosis can be clinically important even when there is no significant blockage in a coronary artery.
• Heart failure. Women are more likely to develop heart failure with preserved ejection fraction (HFpEF), and may experience a substantial burden of comorbidities, depression, stroke, and reduced quality of life.
• Cardiomyopathies. Takotsubo (stress) cardiomyopathy disproportionately affects women. Peripartum cardiomyopathy is unique to women.
• Arrhythmias. Hormonal changes can influence how arrhythmias present and the risk of developing one.
• Vascular disease. Women with aortic aneurysmal or peripheral arterial disease may face increased complication risks.
• Stroke. Women have sex-specific and life-stage-specific stroke risks, including risks associated with pregnancy and postmenopausal aging.

Pregnancy and Menopause Are Important Cardiovascular Life Stages

Cardiovascular risk isn’t static; it shifts across a woman’s life. Pregnancy-related complications and a history of peripartum cardiomyopathy are important parts of the picture, as is the menopausal transition, which brings hormonal changes that can influence cardiovascular risk. Relevant autoimmune or inflammatory conditions matter too, alongside the more familiar risk factors: blood pressure, diabetes or prediabetes, lipid profile, smoking or nicotine exposure, family history, obesity and physical inactivity, and kidney disease.

Know Your Risk, and Don’t Wait for a Classic Presentation

Rather than assuming a textbook presentation, it’s worth asking yourself:

• Do you know your blood pressure and cholesterol numbers?
• Have you ever been told you have diabetes, prediabetes, or kidney disease?
• Do you have a family history of premature heart disease or stroke?
• Have you experienced unusual shortness of breath, fatigue, palpitations, or reduced exercise tolerance?
• Did you experience any significant cardiovascular complications during pregnancy?
• Have your cardiovascular risk factors changed since menopause?

Chest discomfort or pressure, shortness of breath, unusual fatigue, reduced exercise tolerance, palpitations, dizziness or fainting, and other new or unexplained symptoms are all worth raising with your healthcare provider, even if they don’t match the stereotypical presentation of a heart attack.

When to Seek Medical Attention

New, severe, persistent, or concerning cardiovascular symptoms require prompt medical assessment. Don’t dismiss symptoms simply because they don’t fit the classic pattern.

Talk with your OFHC healthcare team about your cardiovascular risk factors and how they may change throughout your life. Knowing your risk factors and discussing new or unexplained symptoms with your healthcare provider supports earlier recognition and treatment. Your heart health matters at every stage of life.

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Disclaimer: The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information does not substitute for professional diagnosis and treatment. Please do not initiate, modify, or discontinue any treatment, medication, or supplement solely based on this information. Always seek the advice of your healthcare provider first. Full Disclaimer.