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Heart Disease in Women

What is heart disease?

Heart disease is a general term that includes many types of heart problems. It's also called cardiovascular disease, which means heart and blood vessel disease.

Coronary artery disease (also called coronary heart disease) is the most common type of heart disease in both men and women. It happens slowly over time when a sticky substance called plaque builds up in the arteries that supply your heart muscle with blood. The plaque narrows or blocks blood flow to the heart muscle and can lead to:

  • Angina - chest pain from lack of blood flow
  • Heart attacks - when part of the heart muscle dies from loss of blood flow
  • Heart failure - when your heart can't pump enough blood to meet your body's needs
  • Arrhythmia - a problem with the rate or rhythm of your heartbeat
How does heart disease affect women?

In the United States, heart disease is the number one cause of death in women. But women are often not diagnosed with heart disease as quickly as men are. That's because:

  • Women are more likely than men to have "silent" heart disease, meaning that they don't have symptoms.
  • Health care providers may not recognize heart disease in women because women's symptoms may be different from men's symptoms.
  • Women are more likely than men to have certain types of heart disease that can be harder to diagnose.

A delay in diagnosis may mean a delay in medical care that could help prevent serious problems, such as a heart attack. That's why it's important to learn about your risk for heart disease, the symptoms in women, and how to keep your heart healthy.

What types of heart disease do women get?

Women can get any type of heart disease. Like men, the most common type of heart disease among women is coronary artery disease. But there are certain types of heart disease which are less common, but affect women more often than men:

  • Coronary microvascular disease - Chest pain from spasms (sudden tightening) in the smallest arteries of the heart that pinch off blood flow. It typically happens during rest or routine activities. This serious condition increases your risk of having a heart attack or other heart diseases. This type may be harder to diagnose since blockages in smaller arteries can be harder to see on imaging tests.
  • Broken heart syndrome - Strong chest pain or other signs that look like a heart attack. It's caused by the stress of powerful emotions, such as deep grief, anger, or surprise. It can happen even if you're healthy. It mostly affects women after menopause and usually doesn't cause any lasting damage.
  • Variant angina - A rare type of strong chest pain from spasms in the heart arteries. The pain usually happens in a pattern during sleep. Variant angina rarely causes a heart attack.
Which women are more likely to develop heart disease?

Your risk for developing heart disease increases with:

  • Menopause. Women can develop heart disease at any age, but your risk increases after your periods stop, usually by age 55. Before menopause, your body makes more estrogen (a female hormone) which helps protect against heart disease. That's why women generally develop coronary artery disease 10 years later than men. During and after menopause, estrogen levels drop and your risk for heart diseases goes up. If your periods stop before age 40, your risk will be higher than other women your age.
  • Family history of heart disease. Your risk for heart disease may be higher if your:
    • Mother or sister had heart disease before age 65.
    • Father or brother had heart disease before age 55.
  • Problems during pregnancy, such as high blood pressure, gestational diabetes, anemia, and high blood pressure.
  • Use of hormonal birth control (pills, patches, or vaginal rings with estrogen and progesterone).
  • Endometriosis.
  • Polycystic ovary syndrome.
  • Inflammatory and autoimmune diseases.
  • Metabolic syndrome.
  • Mental health issues, such as stress, anxiety, or depression.
  • Health risks from a lack physical activity.
  • Obesity or being overweight.
  • Diabetes.
  • Low HDL cholesterol levels.
  • Mild to moderate high blood pressure.
  • Smoking.

If you have one or more risks for heart disease, ask your health care provider for help understanding your risk level. Ask if you need any heart tests to help catch heart disease early.

What are the symptoms of heart disease and heart attack in women?

When women have symptoms of heart disease, they may include:

  • Pain or discomfort in the chest that may be dull and heavy or sharp
  • Pain in the neck, jaw, throat, upper belly, or back
  • Nausea or vomiting
  • Unusual fatigue
  • Shortness of breath (feeling like you can't get enough air) during physical activity

Women who have coronary artery disease are more likely than men to have chest pain when resting or doing daily activities, rather than during exercise. They're also more likely than men to feel chest pain from mental stress.

Symptoms of a heart attack in women may also be different than in men. Chest pain is the most common symptom for both sexes. It may feel like crushing or squeezing. But women are somewhat less likely than men to have chest pain.

During a heart attack, women may feel:

  • Pressure or tightness in the chest
  • Pain in the upper back, arms, neck, jaw or throat
  • Dizziness
  • Unusual fatigue
  • Indigestion, heartburn, nausea, or vomiting
  • Stomach pain
  • Shortness of breath

Heart attacks usually don't look like the sudden, dramatic events we see in the movies. The symptoms may be mild or strong. They may start slowly. They can stop and then come back.

Can heart disease in women be prevented?

You can help lower your risk by:

  • Learning how to prevent heart disease and making heart-healthy habits part of your daily life.
  • Asking your provider about your personal risk for heart disease and the best way to manage your heart health.

Remember, women can have heart disease without symptoms. But if you pay attention to your risk for heart disease, you can take action to prevent problems or keep them from getting worse.

NIH: National Heart, Lung, and Blood Institute

Heart Failure

What is heart failure?

Heart failure means that your heart can't pump enough oxygen-rich blood to meet your body's needs. Heart failure doesn't mean that your heart has stopped or is about to stop beating. But without enough blood flow, your organs may not work well, which can cause serious problems.

Heart failure can affect one or both sides of your heart:

  • With right-sided heart failure, your heart is too weak to pump enough blood to your lungs to get oxygen.
  • With left-sided heart failure, your heart can't pump enough oxygen-rich blood out to your body. This happens when the left side of your heart becomes either:
    • Too weak to pump enough blood.
    • Too thick or stiff to relax and fill with enough blood.

Left-sided heart failure is more common than right-sided heart failure.

What causes heart failure?

Heart failure can start suddenly after a medical condition or injury damages your heart muscle. But in most cases, heart failure develops slowly from long-term medical conditions.

Conditions that can cause heart failure include:

  • Arrhythmia (a problem with the rate or rhythm of your heartbeat)
  • Cardiomyopathy
  • Congenital heart defects or other types of heart diseases that you are born with
  • Coronary artery disease
  • Endocarditis
  • Heart attack
  • Heart valve diseases
  • High blood pressure
  • A blood clot in your lung
  • Diabetes
  • Certain severe lung diseases, such as COPD (chronic obstructive pulmonary disease)
  • Obesity

Over time, left-sided heart failure can lead to right-sided heart failure.

Who is more likely to develop heart failure?

Heart failure can happen at any age. It happens to both men and women, but men often develop it at a younger age than women. Your chance of developing heart failure increases if:

  • You're 65 years old or older. Aging can weaken and stiffen your heart muscle.
  • Your family health history includes relatives who have or have had heart failure.
  • You have changes in your genes that affect your heart tissue.
  • You have habits that can harm your heart, including:
    • Smoking
    • Eating foods high in fat, cholesterol, and sodium (salt)
    • Having an inactive lifestyle
    • Alcohol use disorder (AUD)
    • Illegal drug use
  • You have other medical conditions that can affect your heart, including:
    • Any heart or blood vessel conditions, including high blood pressure
    • Serious lung diseases
    • Infection, such as HIV or COVID-19
    • Obesity
    • Diabetes
    • Sleep apnea
    • Chronic kidney disease
    • Anemia
    • Thyroid disease
    • Iron overload disease
    • Cancer treatments that can harm your heart, such as radiation and chemotherapy
  • You are African American. African Americans are more likely to develop heart failure and have more serious cases at younger ages than people of other races. Factors such as stigma, discrimination, income, education, and geographic region can also affect their risk of heart failure.
What are the symptoms of heart failure?

The symptoms of heart failure depend on which side of your heart is affected and how serious your condition has become. Most symptoms are caused by reduced blood flow to your organs and fluid buildup in your body.

Fluid buildup happens because the flow of blood through your heart is too slow. As a result, blood backs up in the vessels that return the blood to your heart. Fluid may leak from the blood vessels and collect in the tissues of your body, causing swelling (edema) and other problems.

Symptoms of heart failure may include:

  • Feeling short of breath (like you can't get enough air) when you do things like climbing stairs. This may be one of the first symptoms you notice.
  • Fatigue or weakness even after rest.
  • Coughing.
  • Swelling and weight gain from fluid in your ankles, lower legs, or abdomen (belly).
  • Difficulty sleeping when lying flat.
  • Nausea and loss of appetite.
  • Swelling in the veins of your neck.
  • Needing to urinate (pee) often.

At first you may have no symptoms or mild symptoms. As the disease gets worse, your symptoms will usually bother you more.

What other problems does heart failure cause?

Fluid buildup and reduced blood flow to your organs can lead to serious problems, including:

  • Breathing problems from fluid in and around your lungs (also called congestive heart failure)
  • Kidney or liver damage, including cirrhosis
  • Malnutrition if fluid buildup makes eating uncomfortable or if your stomach doesn't get enough blood flow to digest food properly
  • Other heart conditions, such as irregular heartbeat and sudden cardiac arrest
  • Pulmonary hypertension
How is heart failure diagnosed?

To find out if you have heart failure, your health care provider will

  • Ask about your medical history, including your symptoms
  • Ask about your family health history, including relatives who have had heart failure
  • Do a physical exam
  • Likely run heart tests and blood tests, including a brain natriuretic peptide (BNP) test

In some cases, your provider may refer you to a cardiologist (a doctor who specializes in heart diseases) for tests, diagnosis, and care.

What are the treatments for heart failure?

Your treatment will depend on the type of heart failure you have and how serious it is. There's no cure for heart failure. But treatment can help you live longer with fewer symptoms.

Even with treatment, heart failure usually gets worse over time, so you'll likely need treatment for the rest of your life.

Most treatment plans include:

  • Taking medicine
  • Eating less sodium and drinking less liquid to control fluid buildup
  • Making other changes, such as quitting smoking, managing stress, and getting as much physical activity as your provider recommends
  • Treating any conditions that may make heart failure worse

You may need heart surgery if:

  • You have a congenital heart defect or damage to your heart that can be fixed.
  • The left side of your heart is getting weaker and putting a device in your chest could help. Devices include:
    • An implantable cardioverter defibrillator.
    • A biventricular pacemaker (cardiac resynchronization therapy).
    • A mechanical heart pump (a ventricular assist device (VAD) or a total artificial heart).
  • Your heart doctor recommends a heart transplant because your heart failure is life-threatening and nothing else is helping.

As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.

Can heart failure be prevented?

You may be able to prevent or delay heart failure if you:

  • Work with your provider to manage any health conditions that increase your risk of developing heart failure
  • Make healthy changes in your eating, exercise, and other daily habits to help prevent heart disease

NIH: National Heart, Lung, and Blood Institute

Helicobacter pylori Infections

Helicobacter pylori (H. pylori) is a type of bacteria that causes infection in the stomach. It is the main cause of peptic ulcers, and it can also cause gastritis and stomach cancer.

About 30 to 40% of people in the United States get an H. pylori infection. Most people get it as a child. H. pylori usually does not cause symptoms. But it can break down the inner protective coating in some people's stomachs and cause inflammation. This can lead to gastritis or a peptic ulcer.

Researchers aren't sure how H. pylori spreads. They think that it may spread by unclean food and water, or through contact with an infected person's saliva and other body fluids.

A peptic ulcer causes a dull or burning pain in your stomach, especially when you have an empty stomach. It lasts for minutes to hours, and it may come and go for several days or weeks. It may also cause other symptoms, such as bloating, nausea, and weight loss. If you have the symptoms of a peptic ulcer, your health care provider will check to see whether you have H. pylori. There are blood, breath, and stool tests to check for H. pylori. In some cases, you may need an upper endoscopy, often with a biopsy.

If you do have a peptic ulcer, the treatment is with a combination of antibiotics and acid-reducing medicines. You will need to be tested again after treatment to make sure the infection is gone.

There is no vaccine for H. pylori. Since H. pylori might spread through unclean food and water, you might be able to prevent it if you:

  • Wash your hands after using the bathroom and before eating
  • Eat properly prepared food
  • Drink water from a clean, safe source

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Hepatitis

What is hepatitis?

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.

Hepatitis can be an acute (short-term) infection or a chronic (long-term) infection. Some types of hepatitis cause only acute infections. Other types can cause both acute and chronic infections.

What causes hepatitis?

There are different types of hepatitis, with different causes:

  • Viral hepatitis is the most common type. It is caused by one of several viruses -- hepatitis viruses A, B, C, D, and E. In the United States, A, B, and C are the most common.
  • Alcoholic hepatitis is caused by heavy alcohol use
  • Toxic hepatitis can be caused by certain poisons, chemicals, medicines, or supplements
  • Autoimmune hepatitis is a chronic type in which your body's immune system attacks your liver. The cause is not known, but genetics and your environment may play a role.
How is viral hepatitis spread?

Hepatitis A and hepatitis E usually spread through contact with food or water that was contaminated with an infected person's stool. You can also get hepatitis E by eating undercooked pork, deer, or shellfish.

Hepatitis B, hepatitis C, and hepatitis D spread through contact with the blood of someone who has the disease. Hepatitis B and D may also spread through contact with other body fluids. This can happen in many ways, such as sharing drug needles or having unprotected sex.

Who is at risk for hepatitis?

The risks are different for the different types of hepatitis. For example, with most of the viral types, your risk is higher if you have unprotected sex. People who drink a lot over long periods of time are at risk for alcoholic hepatitis.

What are the symptoms of hepatitis?

Some people with hepatitis do not have symptoms and do not know they are infected. If you do have symptoms, they may include:

  • Fever
  • Fatigue
  • Loss of appetite
  • Nausea and/or vomiting
  • Abdominal pain
  • Dark urine
  • Clay-colored bowel movements
  • Joint pain
  • Jaundice, yellowing of your skin and eyes

If you have an acute infection, your symptoms can start anywhere between 2 weeks to 6 months after you got infected. If you have a chronic infection, you may not have symptoms until many years later.

What other problems can hepatitis cause?

Chronic hepatitis can lead to complications such as cirrhosis (scarring of the liver), liver failure, and liver cancer. Early diagnosis and treatment of chronic hepatitis may prevent these complications.

How is hepatitis diagnosed?

To diagnose hepatitis, your health care provider:

  • Will ask about your symptoms and medical history
  • Will do a physical exam
  • Will likely do blood tests, including tests for viral hepatitis
  • Might do imaging tests, such as an ultrasound, CT scan, or MRI
  • May need to do a liver biopsy to get a clear diagnosis and check for liver damage
What are the treatments for hepatitis?

Treatment for hepatitis depends on which type you have and whether it is acute or chronic. Acute viral hepatitis often goes away on its own. To feel better, you may just need to rest and get enough fluids. But in some cases, it may be more serious. You might even need treatment in a hospital.

There are different medicines to treat the different chronic types of hepatitis. Possible other treatments may include surgery and other medical procedures. People who have alcoholic hepatitis need to stop drinking. If your chronic hepatitis leads to liver failure or liver cancer, you may need a liver transplant.

Can hepatitis be prevented?

There are different ways to prevent or lower your risk for hepatitis, depending on the type of hepatitis. For example, not drinking too much alcohol can prevent alcoholic hepatitis. There are vaccines to prevent hepatitis A and B. Autoimmune hepatitis cannot be prevented.

NIH: National Institute of Diabetes and Digestive and Kidney Diseases

Hepatitis A

What is hepatitis?

Hepatitis is inflammation of the liver. Inflammation is swelling that happens when tissues of the body are injured or infected. It can damage your liver. This swelling and damage can affect how well your liver functions.

What is hepatitis A?

Hepatitis A is a type of viral hepatitis. It causes an acute, or short-term, infection. This means that people usually get better without treatment after a few weeks.

Thanks to a vaccine, hepatitis A is not very common in the United States.

What causes hepatitis A?

Hepatitis A is caused by the hepatitis A virus. The virus spreads through contact with an infected person's stool. This can happen if you:

  • Eat food made by someone who has the virus and did not properly wash their hands after using the bathroom
  • Drink contaminated water or eat foods that were rinsed with contaminated water
  • Have close personal contact with someone who has hepatitis A. This could be through certain types of sex (like oral-anal sex), taking care of someone who is ill, or using illegal drugs with others.
Who is at risk for hepatitis A?

Although anyone can get hepatitis A, you are at higher risk if you:

  • Travel to developing countries
  • Have sex with someone who has hepatitis A
  • Are a man who has sex with men
  • Use illegal drugs
  • Are experiencing homelessness
  • Live with or care for someone who has hepatitis A
  • Live with or care for a child recently adopted from a country where hepatitis A is common
What are the symptoms of hepatitis A?

Not everyone with hepatitis A has symptoms. Adults are more likely to have symptoms than children. If you do have symptoms, they usually start 2 to 7 weeks after infection. They can include:

  • Dark yellow urine
  • Diarrhea
  • Fatigue
  • Fever
  • Gray- or clay-colored stools
  • Joint pain
  • Loss of appetite
  • Nausea and/or vomiting
  • Abdominal pain
  • Yellowish eyes and skin, called jaundice

The symptoms usually last less than 2 months, although some people can be ill for as long as 6 months.

You are at a higher risk of getting a more severe infection from hepatitis A if you also have HIV, hepatitis B, or hepatitis C.

What other problems can hepatitis A cause?

In rare cases, hepatitis A may lead to liver failure. This is more common in adults over age 50 and in people who have another liver.

How is hepatitis A diagnosed?

To diagnose hepatitis A, your health care provider may use many tools:

  • A medical history, which includes asking about your symptoms
  • A physical exam
  • Blood tests, including tests for viral hepatitis
What are the treatments for hepatitis A?

There is no specific treatment for hepatitis A. The best way to recover is to rest, drink plenty of liquids, and eat healthy foods. Your provider may also suggest medicines to help relieve symptoms. In more severe cases, you may need care in a hospital.

Can hepatitis A be prevented?

The best way to prevent hepatitis A is to get the hepatitis A vaccine. It is also important to have good hygiene, especially washing your hands thoroughly after you go to the bathroom.

National Institute of Diabetes and Digestive and Kidney Diseases

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