Heart Disease Is Women’s Greatest Health Threat

Did you know that cardiovascular disease kills more women than all forms of cancer combined each year? Though heart disease is the leading cause of death for American women, too many are still unaware of the biology, risk factors, and symptoms of cardiovascular issues that are unique to women.

Researchers have found many sex-related differences in the cardiovascular system and unique risk factors that may lead to worse outcomes for women. That is why physicians like Katherine Shreyder, MD, are working to raise awareness of the fact that heart disease can present in dramatically different ways between the sexes.

As the newest cardiologist at St. Clair Health and first female physician to practice with St. Clair Medical Group Cardiology, Dr. Shreyder often finds herself educating patients about these differences to support their heart health. They include:

Different Biology

According to Dr. Shreyder, “The average age at which a man experiences his first heart attack is about 65, while the average age for women is 72. Researchers believe this discrepancy is due to the protective factor of naturally occurring estrogen.”

Additionally, women are more prone to artery spasms, vessel tears, and stress-induced cardiomyopathy as they have smaller caliber arteries—even when adjusted for size differences between men and women. Men typically develop plaque buildup in the largest arteries that supply blood to the heart, while women are more likely to develop this buildup in the heart’s smallest blood vessels known as the microvasculature.

Different Risk Factors For Heart Disease

Though some risk factors of heart disease are prevalent in both sexes, Dr. Shreyder emphasizes that conditions unique to or prevalent in women may increase their chances for heart problems. These conditions include high blood pressure and diabetes during pregnancy, preeclampsia, polycystic ovarian syndrome (PCOS), breast cancer, and autoimmune disorders such as rheumatoid arthritis and lupus.

Different Heart Attack Symptoms

The most common heart attack symptom in women is the same as in men—some type of chest pain, pressure, or discomfort that lasts more than a few minutes. However, chest pain is not always the most severe or noticeable symptom in women.

Symptoms unique to women may include discomfort in the neck, jaw, upper back, or upper belly; shortness of breath; pain in one or both arms; nausea or vomiting; unusual fatigue; or heartburn and indigestion. Dr. Shreyder continues, “Because these symptoms may not be as clear as the crushing chest pain often associated with heart attacks, research shows nearly half of all women ignore symptoms or wait to seek medical care. This can lead to a late diagnosis, delayed treatment, and complications down the road.”

Dr. Shreyder is on a mission to raise awareness of heart disease among women and address the gender gap in care to improve health outcomes for women in Southwestern Pennsylvania. In fact, she is striving to introduce a new women’s heart health program at St. Clair Health this year. By collaborating with physician colleagues in obstetrics and gynecology and primary care, Dr. Shreyder hopes to help more women better recognize the signs and risk factors of heart disease.

Nearly 45% of women age 20 years and older are living with some form of cardiovascular disease, and occurrence of heart failure increases with age. But the good news is that most heart and stroke events can be prevented through education and lifestyle changes. For example, you should eat healthy; get active; maintain a healthy weight; quit smoking or stay away from second-hand smoke; and control cholesterol, diabetes, and blood pressure.

In addition to learning more about heart disease and taking the necessary steps to reduce their risk, women should see a physician regularly to ensure they are in good health. The most important step in diagnosing heart disease is to find a physician you trust—one who specializes in cardiovascular care, can analyze your symptoms and will choose the best diagnostic approach to treat any conditions.


Katherine Shreyder, M.D.Katherine Shreyder, MD, received her medical training in Moscow, Russia, and worked as a physician there for 13 years before immigrating to the United States. She completed her residency at Texas Tech University Health Sciences Center and a fellowship at Lahey Hospital and Medical Center in Massachusetts. She is board certified in cardiovascular medicine and practices with St. Clair Medical Group.