Common emergency symptoms can differ in men and women
Thursday 29 October 2020
Did you know that common emergency symptoms can differ for men and women? Often chest pain is thought to be the most common symptom for a heart attack – and it is common in men. However, only about half of all women who have a heart attack actually report having chest pain.
Early treatment is critical for both heart attacks and strokes, two of Australia’s biggest killers. Knowing the common emergency symptoms and seeking immediate medical attention could save your life or save your loved one.
Cardiovascular disease – commonly known as ‘heart disease’ – is a term used when referring to a disease or condition which affects the heart or blood vessels. These include coronary heart disease (also known as ‘coronary artery disease’ and ‘ischaemic heart disease’), heart failure, arrhythmias, angina and others.
Heart attacks are a common, potentially fatal, consequence of coronary heart disease. They occur when the blood flow to the heart is suddenly interrupted. The longer a blockage is left untreated, the more damage occurs to your heart muscles as they need a constant supply of oxygen-rich blood in order to pump blood all over your body through the circulatory system.
While many people associate heart attacks with middle aged or older men, coronary heart disease, the most common form of cardiovascular disease which can cause heart attacks, is the leading cause of death for both men and women in Queensland. Subtle or uncharacteristic symptoms are at the heart of the problem for women as it can cause them to delay medical treatment.
Heart attack warning signs and symptoms can differ for men and women. A person having a heart attack is usually conscious and may be complaining of chest discomfort or pain or any of the following symptoms.
Men commonly experience:
- chest pain or discomfort
- shortness of breath
Men may also experience:
- arm pain
- back, neck, jaw and shoulder pain
- cold sweat
Women may experience:
- back, neck or jaw pain or tightness
- a burning sensation in the chest (similar to heartburn)
- chest discomfort
- shortness of breath
- stomach or arm pain
Some people, typically women, may not experience the classic ‘crushing chest pain’ you expect from a heart attack. Heart attacks are often thought to be sudden, painful events that cause victims to collapse to the floor. However, for many their symptoms and pain can be gradual and mistaken for muscle ache or indigestion.
We know what you’re thinking – if symptoms can come on suddenly or develop over minutes and get progressively worse, and you may experience just one of these symptoms or a combination of them – how do you know if you’re having a heart attack?
No two heart attacks are the same, even for the same person. The only way to know if you’re experiencing a heart attack is to seek urgent help and a medical diagnosis. At worst, you’ll get the good news that you may have something less serious. At best, you will receive the life-saving treatment you need.
If you’re experiencing the warning signs of a heart attack or are worried you or someone you know is having a heart attack – tell someone. If symptoms are severe, or getting worse, or last for more than 10 minutes, call Triple Zero (000) immediately. You can download a heart attack warning signs action plan here.
Why are men and women different?
Women’s experience of heart attacks and heart disease differ from men because:
- Women’s symptoms of heart disease can arise at a much later stage in the illness than men
- Women’s symptoms can be milder, vague or unusual
- Some tests used to diagnose heart disease are less accurate in women than in men
- In the event of a heart attack, women are also less likely than men to seek help quickly
- There is also less awareness of the risk and different warning signs of heart attack and heart disease in females.
Because heart disease in women often goes undetected which can delay treatment, the damage caused can be more advanced and outcomes can be poorer than for men.
Stroke is also one of Australia’s biggest killers. It kills more women than breast cancer and more men than prostate cancer. Did you know every 9 minutes someone has a stroke in Australia?
A stoke is a medical emergency where time is critical as it occurs when the blood supply to your brain is interrupted. There are two types of strokes, both stop blood getting to areas of your brain and can cause death or disability. When an artery in the brain becomes blocked by a clot, this is called an ischaemic stroke. When a blood vessel in the brain breaks or bursts causing bleeding, this is known as a haemorrhagic stroke. Damage to an area of your brain can impact how you think, behave, use words, swallow, feel, touch, see, and move your body.
To recognise the main symptoms of a stroke, remember the word 'FAST': Face-Arms-Speech-Time.
- FACE — Check their FACE. Has their mouth drooped? Their face may have dropped on one side, the person may not be able to smile or their mouth or eyes may have drooped.
- ARMS — Can they lift both ARMS? The person may not be able to lift one or both arms and keep them there because of arm weakness or numbness.
- SPEECH — Is their SPEECH slurred? Do they understand you? Their speech may be slurred or garbled, or the person may be unable to talk at all despite appearing to be awake.
- TIME — TIME is critical. If you see any of these signs, call triple zero (000) immediately.
The symptoms described in the FAST test will identify about 9 out of 10 strokes. However, the signs and symptoms of a stroke can still vary from person to person as your symptoms and the overall impact of the stroke will depend upon which area of your brain is affected (different parts of your brain control different parts of your body) and the extent of the damage.
Other signs of a stroke which may occur alone or in combination include:
- Paralysis, weakness or numbness of the face, arm or leg on either or both sides of the body
- Difficulty speaking or understanding
- Dizziness, loss of balance or an unexplained fall
- Loss of vision, sudden blurring or decreased vision in one or both eyes
- Headache, usually severe and abrupt onset or unexplained change in the pattern of headaches
- Difficulty swallowing
Symptoms of a stroke often come on suddenly, but what happens if your symptoms disappear? Even if your symptoms disappear within a few minutes, you or the person having the stroke should still immediately go to hospital for an assessment. It may mean you have had a transient ischaemic attack (TIA) (sometimes called a ‘mini-stroke’), where a small blood clot causes a sudden lack of blood flow to the brain but dissolves before permanent damage occurs. This is a very important warning that you are at risk of a stroke as about 1 in 3 people who have an ischaemic stroke have previously had a TIA.
Increased risk in women
Whilst symptoms for men and women are often the same for a stroke, women have a higher lifetime risk of stroke and have a number of gender-specific risk factors. Many of these risk factors for stroke also increase women’s risk of heart disease. In Australia, 9 in every 10 women have one risk factor for heart disease, and half of all women have 2 or 3 risk factors.
Factors which specifically increase women’s risk of stroke include:
- Migraines with visual aura such as flashing lights, blind spots, difficulty focusing on things – this is a risk, especially if combined with smoking and the oral contraceptive pill or hormone replacement therapy.
- Some types of the oral contraceptive pill and hormone replacement therapy used to treat menopausal symptoms can increase the likelihood of blood clotting and so increase the risk of stroke in some women.
Other risk factors for stroke and heart disease affecting women include:
- Smoking – Women who smoke have a 25% greater risk of coronary heart disease than male smokers. Evidence suggests taking the oral contraceptive pill increases the risk of heart disease and stroke in women who smoke.
- Women can also have the added risk factors of pre-eclampsia or gestational diabetes (during pregnancy), which may increase the chances of developing heart disease later in life. These conditions during pregnancy can also increase a woman’s risk of stroke in the third trimester and for three months after giving birth.
- Menopause – Women’s risk of heart disease increases significantly after reaching menopause. This is believed to be linked to lower levels of the hormone oestrogen which provide less protection from heart disease. However, it is also important to note that hormone replacement therapy used to treat menopausal symptoms increases the risk of developing heart disease or stroke by a small degree.
Gender diversity and common emergency symptoms
People who identify as trans, non-binary or gender diverse may wonder which symptoms they should be on the lookout for in an emergency. You should always talk to your doctor about your specific situation and medical history to get their advice and an assessment of your risk of having a heart attack or stroke. As a general rule, if the symptom is unusual, severe, or long-lasting; you should seek medical attention early. If you think you could be having a heart attack or stroke, call triple zero (000) for an ambulance immediately, even if you don’t think you have stereotypical symptoms.
Know your risk: book a heart health check
Do you know what your risk of having a heart attack or stroke is? 1.4 million Australians have a high chance of having a heart attack or stroke in the next five years, but many are unaware of this risk.
The main risk factors affecting both men and women include:
- high blood pressure
- high blood cholesterol
- lack of physical activity
- being above a healthy weight
- unhealthy diet, including eating foods with saturated fats or added salt and low fruit and vegetable intake
- excessive alcohol consumption
- depression and social isolation
You should also be aware of atrial fibrillation, which is associated with one in four strokes. Atrial fibrillation causes an irregular heartbeat. This can allow blood clots to form in the heart which can then break away from the heart wall and travel to the brain, where it may cause a stroke. To find out if you have atrial fibrillation or if you experience symptoms such as palpitations, weakness, faintness or breathlessness, see a doctor for diagnosis and treatment. Your doctor will advise you on how best to manage your atrial fibrillation.
Anyone 45 years and over or 30 years and over for Aboriginal and Torres Strait Islander peoples should have a regular heart health check with their doctor. Heart health checks can identify issues and determine your risk factor by checking your blood pressure, cholesterol and blood sugar levels. Your GP can support you to make positive changes to lower this risk.
Reduce your risk
While ageing, your family history, and already having had a stroke are risk factors that cannot be changed, more than 80% of strokes can be prevented in Australia and two-thirds of heart disease deaths in Queensland are preventable.
Whether you're a woman or a man, here’s 5 ways to reduce your risk of heart disease:
- Quit smoking
Smoking damages the blood vessels leading to your heart, brain and other parts of your body. This makes you four times more likely to die of heart attack or stroke. Quitting can be difficult, but you can do it with planning, practise, and help. You can talk to your doctor, visit QUIT HQ to start your quit journey or if you need immediate help call Quitline on 13 78 48.
- Exercise regularly
You’ve heard it before, but we’ll say it time and time again: keep moving your body. Keeping active helps to control the common risk factors, including high cholesterol, high blood pressure and being overweight.
Most of us should be aiming for at least 30 minutes of moderate intensity physical activity on most (preferably all) days of the week. It’s always a good idea to talk to your doctor to determine what exercises are right for you before you start a new physical activity routine.
- Healthy eating
Having both a healthy diet and regular physical exercise helps you maintain a healthy weight which reduce your chances of developing high blood pressure. Healthy eating for a healthy heart is all about maintaining a balanced diet which is naturally low in saturated and trans fats, salt and added sugar. It’s rich in wholegrains, fibre, antioxidants and unsaturated fats.
- Eating more fruit and vegetables
- Swapping to wholegrain
- Making healthier fat choices by including monounsaturated and polyunsaturated (omega-3 and omega-6) fats in your diet (can be found in avocados, nuts, fish and sunflower seeds)
- Using herbs and spices instead of too much salt.
Talk to your GP or a dietitian about your diet and how it affects your cholesterol levels, blood pressure and body weight.
- Reduce your alcohol consumption
Heavy drinking can lead to high blood pressure and an irregular heartbeat (atrial fibrillation). Both are major risk factors for heart attack or stroke. Excessive alcohol consumption multiplies the risk of stroke by more than 3 times. The less alcohol you choose to drink, the lower the risk to your health. It’s important to assess your relationship with alcohol and make healthier choices.
- Understand and control your blood cholesterol and blood pressure
Check out our blogs: Your blood cholesterol explained and Under pressure: how much do you know about blood pressure? A key step in controlling your blood cholesterol levels and blood pressure is seeing your doctor for a heart health check and finding out what they are and how to manage them.