Heart pain in women

Heart pain in women: a symptom that begins to trouble most frequently after menopause, when due to the absence of  estrogen hormones, women lose their „natural” protection against cardiovascular events. According to the studies made among patients with heart attack, heart pain in women is not a hallmark symptom as it is in men. This means that during a heart attack, heart pain in women is less likely to occur and we must pay attention to other signs and symptoms if we don’t want to miss a heart disorder. Although women lose their protection against cardiovascular disease after menopause, estrogen replacement must be indicated only in well selected cases, because this treatment can determine breast or endometrial cancer, blood cloths and stroke etc.

How can estrogen hormones prevent heart pain in women?

It is simple. Estrogen has an important role in lipid metabolism: these hormones decrease the level of LDL-cholesterol and increase the HDL cholesterol (also called „the healthy” cholesterol as it protects against atherosclerosis). Estrogens tend to decrease serum cholesterol concentrations and to increase serum triglyceride concentrations. The overall effect of these changes, together with the effects on blood vessels, is to protect against atherosclerosis and heart pain in women before menopause. As atherosclerosis is the most important cause for heart attacks and chronic heart ischemia (heart disease caused by insufficient oxygenation of the heart tissues, which occurs when blood vessels are blocked by atherosclerosis) it is clear now why estrogen is so important and how can this hormone prevent heart pain in women.

Heart pain in women, what does it mean?

Heart pain in women or chest pain are very often among old patients and challenge the doctor to consider a lot of differential diagnosis, although sometimes it is almost impossible to separate them. For example, a pathology of the spine that presses nerve roots can determine an intense pain, sometimes unbearable, radiating towards the abdomen or chest and can easily mimic a heart pain. An esophagitis with burning sensation in the chest, can be mistaken as a heart symptom, but it responds well to the medication used in ulcer treatment and the duration of symptoms is variable. Heart pain in women doest mean necessary that it is a heart attack, sometimes it is caused by a heart muscle infection or disorder. Other causes for heart pain are abnormal dilated blood vessels called aneurism or chest trauma. In some patients, during heart attack, the pain is felt in the upper part of the abdomen and it can be confused with a stomach or liver disease (like ulcer, gastritis etc.).

How do we manage heart pain?

Heart pain it is always a very disturbing symptom, described by patients as a sensation of pressure on the chest or constriction, but sometimes, associated with palpitations (irregular heart beats), shortness of breath, fatigue, sweating, agitation or even fainting. In conclusion, heart pain in women and men  can be treated with beta-blockers (drugs that increase heart tissues oxygenation, an example of such a drug is metoprolole), calcium channels blockers (make heart blood vessels larger; e.g. amlodipine) or the well known nitroglycerin.