​Do women have worse outcomes after a heart attack? Experts explain why​

The symptom and severity of heart attack in women are as alarming as it is in men. Women tend to miss several symptoms of heart attack and this worsens the condition in them. As per the Indian Heart Association, nearly 25% of deaths in women happen due to heart attacks. In view of the severity of heart attacks in women, it is imperative to know what causes heart attacks in women and why women have worse outcomes after a heart attack. We at ETimes Lifestyle spoke to Dr. Sameer Gupta, Senior Interventional Cardiologist, Group Director - Cath Labs, Director - Metro Group of Hospitals, Noida.

“A heart attack is a life-threatening condition that occurs when the blood flow to a part of the heart muscle is blocked, causing damage to the heart muscle. Heart attack is a common condition that affects millions of people worldwide, and it is a leading cause of death in both men and women. However, research consistently indicates that women tend to experience worse outcomes after a heart attack compared to their male counterparts,” says Dr Gupta. “This gender disparity has sparked widespread concern and calls for deeper investigation into the underlying factors responsible for this discrepancy. Women are more likely to die from a heart attack than men, and they are also more likely to experience complications such as heart failure, stroke, and recurrent heart attacks,” he says.

Dr Gupta: Women have different symptoms of a heart attack compared to men, leading to delayed recognition. Men usually experience chest pain or discomfort as the main symptom, while women may have subtler symptoms like fatigue, shortness of breath, nausea, vomiting, and back or jaw pain. These symptoms can be mistaken for other conditions, causing a delay in seeking medical help. This delay can result in more severe damage to the heart muscle, worsening the outcome of a heart attack.

“The health-seeking behaviors of women can be greatly influenced by societal and cultural factors. In certain cultures, women tend to prioritize their caregiving duties over their own health, sometimes dismissing or downplaying symptoms that they perceive as not being serious enough. Additionally, societal expectations can contribute to women adopting less effective stress coping mechanisms, thereby increasing their risk factors for heart disease,” says Dr Gupta and highlights the insignificance of women and their health in families.

Dr Gupta stresses the hormonal constituency of women and how it impacts their heart health. “Estrogen, found at higher levels in women, offers heart protection. However, during menopause when estrogen levels decrease, women become more susceptible to heart disease. Consequently, women tend to develop heart disease later in life compared to men, but are also more vulnerable to the effects of a heart attack,” he explains.

“Biological differences between men and women may also play a role in the varying outcomes. Women's hearts tend to be smaller, and their blood vessels are more prone to microvascular dysfunction, which may affect treatment options and recovery. Hormonal factors, such as fluctuations in estrogen levels during different stages of a woman's life, can also impact cardiovascular health,” explains Dr Gupta.

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“In conclusion, delayed recognition of symptoms, under-representation in clinical trials, hormonal differences, differences in treatment, and socio-economic factors can all affect women's outcomes after a heart attack. Recognizing these factors and addressing them can help to improve outcomes for women with heart disease. This may include increasing awareness of the different symptoms of a heart attack in women, ensuring that women are adequately represented in clinical trials, and providing equitable access to healthcare for all women,” says Dr Gupta.


“It is essential to emphasize that if you have concerns about heart health or any related symptoms, it is always advisable to consult with the doctor. They can provide personalized guidance, perform necessary evaluations, and recommend appropriate diagnostic tests or treatment options based on your specific situation. Remember, early detection and timely intervention are crucial for managing heart conditions effectively,” he says.