MEN VS. WOMEN: UNDERSTANDING HEART DISEASE

Coronary heart disease (CHD) is the leading cause of mortality not only among men, but also among women. For men and women, there are key differences in how heart disease develops, presents, and is managed. These differences are from variations in anatomy, physiology, and hormonal influences, all of which impact cardiovascular health.  

Because of these biological differences, heart disease can progress differently. Women generally have higher heart rates and smaller hearts and arteries than men. This makes women’s arteries more prone to blood clots or blockages and more difficult to repair. 

Men are more likely to survive their first heart attack, the symptoms are often more straight-forward and recognizable, and often recovery is better after an attack. 

RISK FACTORS DIFFER 

While men and women share common risk factors—such as smoking, diabetes, high blood pressure, and a family history of heart disease—some of these pose a greater threat to women. 

For women, the risk of heart disease significantly increases after menopause due to the decline in estrogen levels. Additionally, conditions such as diabetes and autoimmune diseases can further elevate cardiovascular risk. Pregnancy-related complications, including preeclampsia and gestational diabetes, also serve as early indicators of increased cardiovascular risk later in life. 

Men are more likely to develop coronary artery disease (CAD) earlier in life, often due to higher levels of LDL (“bad”) cholesterol and factors like smoking and hypertension. 

However, this is dependent on you being aware of your heart health and risk factors and getting treatment if you have concerns. This is especially important because, although chest discomfort is still the most common sign of a heart problem, not all heart problems come with clear warning signs. Some don’t even happen in your chest.

HEART ATTACK SYMPTOMS DIFFER  

Heart attack symptoms can also differ. For both men and women, the most common signs of a heart attack are chest pain or discomfort, neck or back pain, or nausea. In additional, women can experience a heart attack without chest pressure. They may experience shortness of breath, dizziness, lightheadedness or fainting, upper back pressure, or extreme fatigue. Because symptoms in women can be less specific, they can be harder to recognize as danger signs.  

HOW HEART DISEASE IS DIAGNOSED  

To diagnose heart disease, your doctor will likely start by asking you about your symptoms, when they began and whether anything makes them better or worse. You’ll also discuss your general health and lifestyle – whether you smoke, your activity level, diet, etc.  

For woman it’s also important to discuss whether or not you experienced any pregnancy-related complications. such as preeclampsia or gestational diabetes, and if menopause puts you at a greater risk.  

You may be sent for blood work to determine factors like your lipid profile and complete blood cell count. Your doctor may recommend an arrhythmia monitor, electrocardiogram (EKG), or medical imaging.  

Cardiac imaging can assess the function, electrical changes, and/or blood flow of the heart. Mayfair Diagnostics provides exercise stress testing, myocardial perfusion imaging (MPI), and coronary computed tomography (CT) angiography to help determine your heart health.  

Coronary CT angiography can be used to non-invasively examine the coronary arteries. Using a combination of X-rays and computer technology to produce comprehensive, detailed images, this exam can detect both calcified (hard) plaques and noncalcified (soft) plaques. Patients with family histories of heart disease may be at risk for developing atherosclerotic plaque buildup, blocking or narrowing arteries. On CT, these can be identified even before symptoms of chest pain develop.  

HOW DO I GET CARDIAC IMAGING  

All cardiac imaging exams are offered at our Mayfair Place location. Exercise stress testing and MPI are covered under your Alberta Health Insurance Plan. Coronary CT angiography is available as a private pay exam, not covered by Alberta Health Care. It can be purchased on its own or as part of a Health Assessment package, which provides a discount on multiple imaging exams when purchased together.  

Your health spending account or group medical insurance plan may cover the cost of a private CT that is prescribed by a qualified health care practitioner. You will need to check with your plan administrator for coverage details.  

Whether public or private, medical imaging must be requested by a health care practitioner who will provide a requisition. Your medical and family history, risk factors, and type and duration of symptoms, all affect a referring physician’s decision on which type of imaging is appropriate.  

When we receive your requisition Mayfair Diagnostics will schedule your exam and provide you with detailed information to prepare for it. Once your exam is completed, your images will be reviewed by a specialized radiologist who will compile a report that is sent to your doctor.  

REFERENCES 

Heart and Stroke Foundation of Canada. (2025) Risk and prevention. www.heartandstroke.ca. Accessed February 5, 2025.  

Canadian Women’s Heart Health Centre. (2025) Gender Differences. https://cwhhc.ottawaheart.ca/. Accessed February 5, 2025. 

Brigham and Women’s Hospital. (2025) Heart Disease: 7 Differences Between Men and Women. https://give.brighamandwomens.org/. Accessed February 5, 2025.