Jeanine Romanelli, MD Paul Coady, MD Cardiologists, Lankenau Medical Center The Differences Between a Man and Woman’s Heart

2 Changing Perspective Over the Years 2600 BC- “If you find a man with cardiac discomfort, with pain in his arms, at the side of his heart, death is near.” Ebers Papyrus “I have seen nearly 100 people under this disorder, of which there have been three women…” William Heberdon 1960 AHA conference on Women and Cardiovascular Disease, but was titled “How can I Help My Husband Cope with Heart Disease” The Differences Between a Man and Woman’s Heart

3 The Male Heart The Differences Between a Man and Woman’s Heart While designed to perform the same function, the heart of a man and a woman do have some structural differences Average weight of the male heart is 10 to 12 ounces Average weight of the male heart is 10 to 12 ounces The left ventricle may weigh 25-30% more The left ventricle may weigh 25-30% more The contraction of the male LV may be more vigorous The contraction of the male LV may be more vigorous Congenital abnormalities of cardiac structure such as aortic valve stenosis, coarctation of the aorta, hypoplastic left heart and transposition of the great vessels are more common in males Congenital abnormalities of cardiac structure such as aortic valve stenosis, coarctation of the aorta, hypoplastic left heart and transposition of the great vessels are more common in males

4 The Female Heart The Differences Between a Man and Woman’s Heart - Average weight of the female heart is 8 to 10 ounces The blood vessels that provide blood to the heart, the coronary arteries, are about 2 millimeters narrower in women Some diseases of the heart are more specific to women such as peripartum cardiomyopathy, and stress induced cardiomyopathy

5 Setting the Stage Risk Factors in Men Simply being male increases the risk of heart disease. Men over age 40 have a 17% greater lifetime risk than women. Blood pressure rises earlier in adolescent men Men have cardiac events 8-10 yrs earlier in life Early assessment of blood pressure and cholesterol are essential particularly if there is a family history of early heart disease The Differences Between a Man and Woman’s Heart

6 Setting the Stage Risk Factors in Women oking (the increasing population of smokers is women) Obesity (over 35% of US women are obese) Inactivity (over 25% women do not do leisure activity) Cholesterol (bad goes up and good goes down after menopause) Hypertension (90% risk of a women developing in a lifetime after age 55) Diabetes (more common in adult women) Shaking the Salt Habit Family history Smoking Obesity (over 35% of US women are obese) Inactivity (over 25% women do not do leisure activity) Cholesterol (bad goes up and good goes down after menopause) Hypertension (90% risk of a women developing in a lifetime after age 55) Diabetes (more common in adult women)

7 Symptom Differences in Men The Differences Between a Man and Woman’s Heart Men are more likely to present with “classic” symptoms of coronary heart disease such as chest pain/constriction or tightness. Men are more likely to present with “classic” symptoms of coronary heart disease such as chest pain/constriction or tightness. Associated symptoms of heartburn or nausea/vomiting, sweats, dyspnea are less commonly reported by men and they report radiation of symptoms to arm more frequently. Associated symptoms of heartburn or nausea/vomiting, sweats, dyspnea are less commonly reported by men and they report radiation of symptoms to arm more frequently. Young adult and middle age men are at increased risk for sudden cardiac death compared to their female counterparts. Young adult and middle age men are at increased risk for sudden cardiac death compared to their female counterparts. Prompt recognition of symptoms is important as the vast majority of first heart attack victims presenting to the hospital survive.Prompt recognition of symptoms is important as the vast majority of first heart attack victims presenting to the hospital survive.

8 Symptom Differences in Women Men are more likely to present with “typical” symptoms such as chest pain, shortness of breath but women may just have nausea, fatigue, or arm and neck pain ( they may never have chest pain) Unusual symptoms may result in a delay in testing and therapy Unfortunately testing such as, stress testing, tends to be less accurate in women Both men and women benefit from early detection and treatment Living a healthy life, with a good diet and frequent exercise benefits both genders. Also important to not smoke, have good sugar control if a diabetic and to take medications as prescribed Shaking the Salt Habit Women experience: nausea, extreme fatigue arm and neck pain shortness of breath feelings of anxiety, loss of appetite, malaise Unusual symptoms may result in a delay in testing and therapy Unfortunately testing such as, stress testing, tends to be less accurate in women Call 911 immediately if you experience any of these symptoms

9 Diagnosis and Therapies The Differences in a Man and Woman’s Heart Acute (angioplasty) and chronic (CABG) therapies for coronary heart disease have been studied more extensively in the male population and are well established to be safe and effective. Acute (angioplasty) and chronic (CABG) therapies for coronary heart disease have been studied more extensively in the male population and are well established to be safe and effective. Men are more likely to be given aggressive treatment of high cholesterol and hypertension by their doctors. Men are more likely to be given aggressive treatment of high cholesterol and hypertension by their doctors. Stress testing tends to be less accurate in women The key in both sexes is early recognition of risk factors for heart disease. The key in both sexes is early recognition of risk factors for heart disease. There is NO gender bias for the benefits of weight loss, exercise, smoking cessation, control of diabetes or medicines like aspirin, statins and anti-hypertensives.

10 The Differences Between a Man and Woman’s Heart Questions? To learn more information on ways to maintain your heart health, visit mainlinehealth.org/heart