Women's Heart Health in OMR, Chennai: Specialised Care Guide

Heart disease is the leading cause of death in women worldwide — ahead of every cancer combined. Yet it is still widely thought of as a man's illness, and that misconception has consequences: women are diagnosed later, investigated less thoroughly, and treated less intensively than men with identical symptoms.

The symptoms women actually experience

Crushing central chest pain is the textbook heart attack, and many women do get exactly that. But women are more likely than men to also have, or to have only, symptoms that are easy to attribute to something else:

• Unusual, overwhelming fatigue — sometimes for days or weeks beforehand
• Breathlessness on mild exertion
• Pain in the jaw, neck, upper back or between the shoulder blades
• Nausea, vomiting, or discomfort mistaken for indigestion
• Cold sweats, lightheadedness, or a sense that something is badly wrong
• Pain in one or both arms rather than classically the left

The practical rule: symptoms that come on with exertion and ease with rest deserve a cardiac assessment, wherever in the upper body they are felt. "It is probably just acidity" has cost women their lives.

Call for emergency help if

Chest discomfort lasting more than a few minutes, or any of the above symptoms combined with sweating, breathlessness or collapse, warrants an ambulance — not a wait-and-see, and not a drive by a family member if that will take longer. Aspirin should only be taken if advised by a medical professional.

Risks that apply specifically to women

Standard risk factors — high blood pressure, diabetes, cholesterol, smoking, inactivity, obesity, family history — matter for everyone. But several carry extra weight in women, and some are unique to them.

Pregnancy as a stress test

Complications of pregnancy are among the most useful and most neglected predictors of later heart disease. A history of pre-eclampsia, gestational diabetes, pregnancy-induced hypertension, preterm delivery, or a low birthweight baby raises lifetime cardiovascular risk substantially. If any of these applied to you, mention them at every health check, even decades later. They are rarely asked about.

Hormonal and inflammatory factors

• Polycystic ovary syndrome, through its links to insulin resistance
• Early menopause — before 45 — or surgical removal of the ovaries
• Autoimmune disease such as rheumatoid arthritis or lupus, which are far commoner in women and drive vascular inflammation
• Diabetes, which raises heart disease risk more in women than it does in men
• Smoking, which likewise carries a disproportionate risk for women

Why South Asian women should start earlier

People of South Asian origin develop coronary disease earlier and at lower body weights than many other populations, often with a pattern of central obesity, low HDL and high triglycerides. Waist measurement is frequently more informative than BMI. For women in Chennai, this means risk assessment is worth starting in the thirties rather than waiting until after menopause.

Conditions that disproportionately affect women

Not all heart disease is a blocked major artery, and the alternatives are commoner in women — which is part of why investigations can be falsely reassuring.

• Microvascular disease — the small vessels are affected while the large arteries look normal on angiography. Symptoms are real despite a "clear" scan.
• Spontaneous coronary artery dissection (SCAD) — a tear in an artery wall, typically in younger women, sometimes around pregnancy, often with no conventional risk factors at all.
• Stress cardiomyopathy, in which the heart muscle is temporarily stunned, frequently after severe emotional or physical stress.

If you have persistent exertional symptoms and have been told your arteries are normal, it is reasonable to ask whether microvascular disease has been considered.

What to have checked, and when

From your thirties, and earlier with a strong family history, know these numbers:

• Blood pressure — at least annually
• Fasting glucose or HbA1c
• A full lipid profile
• Waist circumference alongside weight
• Your pregnancy history, recorded where a doctor will actually see it

Around menopause, cholesterol and blood pressure commonly shift unfavourably; this is a sensible point to recheck rather than assume stability.

What genuinely lowers risk

• Stopping smoking — the single largest modifiable factor
• 150 minutes a week of moderate activity; brisk walking counts
• Controlling blood pressure and diabetes to target, not approximately
• A diet weighted toward vegetables, fruit, whole grains, pulses and nuts, with less refined carbohydrate — a shift that fits South Indian cooking easily
• Taking sleep and chronic stress seriously; both are cardiovascular risk factors, not lifestyle luxuries

If you have a history of pre-eclampsia or gestational diabetes, a family history of early heart disease, or symptoms that have been repeatedly put down to acidity or stress, the cardiology team at Iswarya Hospital can carry out a structured risk assessment rather than reassurance alone.

This article provides general health information and is not a substitute for personal medical advice. Please consult a qualified doctor about your own symptoms, risk factors and treatment.