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Published on April 04, 2019

Why Heart Attacks are Happening in Younger People, Especially Women - Q&A with Dr. Katarina Nelson

Young Women are Having Heart Attacks

There have been studies that show an uptick in heart attacks in younger people, especially women. What is the reason for this?

In the last 20 years there has been a dramatic change in lifestyles with increase in obesity among young people. Obesity comes with other diseases such as diabetes, hypertension, chronic kidney disease that are more prevalent among women.

Coronary artery disease has traditionally been seen as an older man’s disease. Why is that?

There are few major reasons for this. Until recently, women were not even included in research for heart diseases. Physicians were taught that it is a disease of middle age to elderly men. As a result many women were frequently misdiagnosed, and even if diagnosed they were less likely to receive guideline-based treatment, less likely to be referred for a cardiac catheterization, less likely to receive cholesterol medication to prevent a future heart attack. Women have worse outcomes when affected by heart attacks.

Sadly, with heart disease being #1 killer for women there is a necessity for education for women in the community and among medical professionals as well.

Does weight factor in to the increase of heart disease in women? What are other factors?

Traditional risk factors such as obesity, physical inactivity, smoking, diabetes, hypertension, but other that are specific to women only such as gestational diabetes, preeclampsia, preterm delivery, hypertensive pregnancy disorder, breast cancer treatments, autoimmune diseases and depression.

What are the symptoms for women who may be having a heart attack?

Only about half of women present with traditional chest tightness or pressure like retrosternal chest pain. Women are much likely to present with dyspnea, unusual fatigue, nausea, dizziness, indigestion or heartburn, back pain or neck pain. When they present with these atypical symptoms their heart attack is more likely to be missed. Again education among women and medical professionals is crucial.

What can young women do to decrease their chances of heart attack?

Healthy diet, maintaining healthy weight, performing regular exercise and early cardiologic evaluation for women with significant family history of premature coronary artery disease or familial hyperlipidemia.

About the Author

Katarina Nelson, MDKatarina Nelson, MD is a cardiologist with Cone Health Medical Group HeartCare at Church Street