When it comes to heart disease, many people think of it as a typical “male disease”. But women die much more often than men from heart failure, as the German Heart Foundation reports. Because heart failure is an often overlooked problem.
Symptoms of heart failure often don’t take heart failure seriously
Heart failure in women – an often overlooked problem. Women make up about half of all those affected in Germany. About a third of more women than men die from it. According to the German Heart Report, 25,318 women died of heart failure (heart failure) in 2016, compared to 15,016 men.
One of the reasons is probably that women don’t take the symptoms seriously. They experience shortness of breath when going up the stairs, have big legs or even a swollen stomach, are tired, feel weak and dizzy. It doesn’t occur to many of them that a weak heart could be behind. “Heart failure is very common in women, especially if the risk factors for high blood pressure, obesity and diabetes are present at the same time”, explains Professor Dr. med. Vera Regitz-Zagrosek.
The internist and cardiologist is a member of the scientific council of the German Heart Foundation and advises women to pay attention to certain points when seeing a doctor in order to protect themselves from easily preventable complications of their disease: if women are short of breath and are quickly exhausted, they should take theirs Ask a doctor to do a cardiac ultrasound (see box). The German Heart Foundation provides information on heart failure in women and many other aspects of heart failure as part of the National Heart Weeks at www.herzstiftung.de
Heart failure is a serious illness. The heart can no longer pump enough blood to the body. The heart pumps oxygen-rich blood through the left half of the heart into the blood vessels, through which it reaches the organs. After passing through the body, the now oxygen-poor blood returns to the heart. It passes through the right half of the heart into the lungs, is again enriched with oxygen and reaches the left half of the heart. The cycle begins again.
If the heart is weak, oxygen can no longer be transported to the lungs
If the heart is too weak, it cannot pump enough blood and therefore oxygen to the lungs or body (systole) or it cannot absorb enough blood (diastole). The latter is much more common in women than in men, as we know today. Women’s hearts are more rigid and therefore can expand less and fill with blood. Experts speak of a so-called diastolic heart failure with continued pumping function.
Experts fear many cases of heart failure going undetected in women
As women age, their hearts become even firmer. Because during menopause the lack of estrogen leads to increased blood pressure and increased connective tissue formation in the heart. “This heart failure caused by a lack of estrogen specific to the body cannot be compensated for by hormone therapy,” said Regitz-Zagrosek, also a Charité principal professor, Universitätsmedizin Berlin. Women not only have a firmer heart, but also smaller than men.
The smaller size is compensated by the fact that their hearts operate with a higher ejection fraction – as it is called in technical jargon – than that of men. The ejection fraction indicates the percentage of blood in the heart that is pumped through the body with each beat. In healthy men this is at least 55% of the blood in the heart, in healthy women more than 60%.
“So far, however, women have been guided by the minimum value for men of 55%,” explains the Berlin cardiologist. “Experts are currently discussing whether the minimum value for women is probably higher than that for men.” In addition: The ejection fraction normally increases with age, more in women than in men, as the size and mass of the heart decreases in both sexes. “This could once again contribute to the fact that the ejection fraction is considered normal, especially in many elderly women, even if they have suffered from a weak heart for a long time,” explains the expert. About half of all heart failure patients admitted to clinics now have a presumed normal ejection fraction. The majority of them are women.
Risk of pregnancy cardiomyopathy and broken heart syndrome
There are other special forms of heart failure in women. So-called perinatal cardiomyopathy (PPCM) can occur in the last third of pregnancy and about six months after birth. Warning signs are sudden shortness of breath, weakness, or water retention in the body. A doctor should be consulted immediately at the first signals.
Experts fear many cases of heart failure going undetected in women. (Image: Robert Kneschke / fotolia.com)
Broken heart syndrome is heart failure that occurs almost exclusively in postmenopausal women. It is often the result of massive emotional stress. The symptoms are similar to those of a heart attack: shortness of breath, chest tightness, severe pain. “The heart contracts more strongly at the base than at the top,” explains Regitz-Zagrosek. “Due to this imbalance in the contraction process, too little blood is ejected and the body is not sufficiently supplied.” This condition is also life threatening. Those affected must immediately alert the emergency doctor (emergency number 112).
Take care of your heart – Professor Vera Regitz-Zagrosek advises women:
– If you have difficulty breathing during minor exertion and quickly become exhausted, ask your doctor for a cardiac ultrasound.
– Have your blood pressure, blood sugar, body weight and blood lipids checked regularly.
– Ask your doctor for a blood test. Iron deficiency can be a sign of a weak heart. In addition, two important markers, the natriuretic peptides ANP and BNP, are elevated in heart failure. Important: in women, slightly elevated values are warning signs.
– Women need lower doses of ACEs and beta blockers than men. Digitalis can cause more complications. The administration of drugs for cardiac arrhythmias should be closely monitored using an electrocardiogram. Ask your doctor if the recommended medicine has been tried on women and if special dosages are recommended.
– In case of possible side effects of a medicine, do not change the dose on your own or stop using it, but talk to your doctor.
– Women benefit greatly from resynchronization therapy, in which the heart is made to contract synchronously with special pacemakers. Do not decline such an offer in advance.
– Exercise outdoors, eat healthy, avoid alcohol and cigarettes.
Author and source information
This text complies with the requirements of specialized medical literature, medical directives and ongoing studies and has been verified by healthcare professionals.
This article is provided for informational purposes only and should not be used for self-diagnosis or self-treatment. It cannot replace a visit to the doctor.