How Diseases Present Differently for Women

If you’ve ever heard an aspirin commercial, seen an American Heart Association ad in the subway, or just paid attention in health class, you might be able to list the signs and symptoms of a heart attack. Chest pain, radiating to your arm or jaw, right? What if those symptoms didn’t apply to you? What if your presentation was entirely different and almost dismissible, purely because of your gender?

My name is Danielle. I’m a registered nurse with critical care certification, and I work almost exclusively with open heart surgery patients in the ICU. I’m here to tell you that as females, we have our own subset of clinical manifestations that are entirely misrepresented to the general public. In the United States, heart disease is the leading killer of women. Each year, coronary artery disease kills ten times more women than breast cancer and domestic violence combined.  Women are also more likely to die from heart disease than men.

Heart attacks, or myocardial infarctions, happen when the arteries that supply blood to your heart become occluded with plaque. The area of the heart that the artery would have supplied blood to is now dead tissue, or ischemic, and can’t pump or beat the way it needs to in order to keep you alive.



In my career, I have met thousands of people. One of the thousands that stands out is one of my first patients. She was in her 40’s, relatively fit, and was working in her garden with her dog, Ham. It was early morning, Ham was enjoying a nap, and she was fixated on her tomato plant. She suddenly felt sick to her stomach. “It felt like heart burn, kind of, but lower down,” I remember her saying. She also noted an aching pain in her mid back. She brushed these two things off, as any busy woman might, and continued on. She woke up several days later, to my voice. Her heart had stopped, and she had collapsed in her yard. Ham was found in a neighbor’s yard by the mail man, who then found my patient and started CPR. You see, time isn’t money. In our world, time is muscle. The sooner we can identify and fix the issue, the better the outcome. This patient of mine, after a long course of treatment, went home to Ham and her tomatoes. I chose to use her as my anecdotal proof because so very many of these patients do not have happy endings.

The biggest risk factor is, surprisingly, genetics. Environmental factors, like smoking, hormone therapy, or eating a pure cheese diet, are going to speed up demise; but if you have the genes that predispose you, you’re far more likely to have a heart attack. So if heart disease runs in your family, I highly recommend getting checked up every now and then. Ask your doctor to take blood samples and test for triglyceride and cholesterol levels. Check your blood pressure regularly. The AHA also recommends a depression screening in women, as well.

Heart attacks aren’t the only thing that can present differently in women. When you think of a stroke, you might think of one-sided facial drooping or slurred speech. In fact, women often experience migraine-like headaches and confusion. Our hormones can predispose us to autoimmune diseases, as well. Diseases like alcoholism and depression might present similarly in both genders, but have vastly different effects on women.


So, what can you do? Health care in our country can seem like wading tumultuous water, but preventative care can and does save lives. Try to find your family history. Genetic screenings, such as 23andme, can be helpful, especially in cases like mine wherein the biological parents and their health histories are unknown. Check with your insurance to see what preventative care is covered, reimbursed, or even rewarded (my insurance gives you 100$ every year that you have something preventative done.) Find out if holistic care is an option for you. Get to know your body and learn to trust your intuition; only you know when something doesn’t feel right. And as always, seek help if you feel like something is off. 

Danielle SchadlerhealthComment