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Heart disease is the number one killer of Americans, and it kills more women than all cancers combined. Surprised?

The medical community now recognizes that women have just as much risk for heart disease as men. While a woman’s estrogen hormone protects her heart somewhat, this changes when she goes through menopause. When estrogen levels drop at this time, a woman’s risk for heart attack rises, catching up to that of a man.

Even so, a woman is not likely to get care for a heart attack as quickly as a man would. That’s in large part because women oftentimes have different symptoms from the expected signs. For example, she might not feel chest pain. Instead, she might be nauseous and very fatigued, signs she might attribute to a stomach bug.

So what’s a woman to do?

First, she should recognize that she’s not immune to heart disease, banishing the thought that it’s something primarily men face. If she has a strong family history of heart disease, she should understand that her risk for heart attack – at any age – could very well be higher than average. It’s also important for women to “know their numbers”: LDL and total cholesterol levels, blood pressure and body mass index.

Women should discuss these numbers with their doctors to better understand their overall risk and create a plan to get these numbers in a healthy range. This can be done by eating the right foods, being more physically active and, perhaps most importantly, quitting smoking.

Yet, it’s possible for even the healthiest person in the world to have a heart attack, so it’s key to recognize that everyone can experience symptoms differently. Women with heart attacks often complain of shortness of breath, fatigue, lightheadedness, sweating, nausea, vomiting, stomach pain, and back, arm, neck or jaw pain. They may or may not have chest pain. In particular, when a woman has two or more of the above symptoms, she should suspect a heart attack and call 911. Women are more likely to think that they are not having a heart attack, but it’s better to err on the safe side with this life or death matter.

It’s also important for women to choose a doctor and hospital system that understand women’s unique needs when it comes to heart disease. The LifeBridge Health Cardiovascular Institute at Sinai and

Northwest hospitals has a strong women’s health focus. The cardiologists who see patients there recognize that women need as much help with their hearts as men do. The ER-7 emergency centers at Sinai and Northwest are both accredited Chest Pain Centers staffed with professionals who know that a woman without classic heart attack symptoms might still be having one.

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