Is women's heart health any different?


FEBRUARY 13, 2022


How is a heart attack different for women?

How is a heart attack different for women? Why is so little known about it? What are the consequences?  A health issue that has been ignored for too long.


The male organism: a universal model?

Until recently, studies of heart disease were mainly focused on men and generalized to women. This was due to the evolution of health sciences in a patriarchal society, largely focused on “men's issues”. However, did you know that one in three Canadian women has cardiovascular disease, and that a woman is 2 times more likely to die of a heart attack than a man? (


In 1990,

Nieca Goldberg, a young cardiologist and now director of the Joan H. Tisch Center for Women's health, was one of the first to focus on women's heart health. When she found that her patient had suffered a heart attack, she began research into women's heart health and became a pioneer in the field. (Nedelman, 2017) She inspired several future studies demonstrating that symptoms of heart problems are mostly more subtle in women than in men.


Today, this research is more than essential, given that, according to the University of Ottawa Heart Institute, coronary heart disease is the leading cause of premature death in women in Canada.


First initiatives in Canada and Quebec




Canadian Women's Heart Health Summit


In April 2016, the first Canadian Women's Heart Health Summit was held in Ottawa. The event, organized by the University of Ottawa Heart Institute and the Heart and Stroke Foundation, represented “the first national event focused on women's heart health in over 15 years” (University of Ottawa Heart Institute, 2017).


Four recommendations* deemed necessary emerged from this meeting:

  • Transform clinical practices and raise awareness among physicians.
  • Create the National Women's Heart Health Alliance to encourage collaboration in research and clinical care.
  • Address the issue from a political perspective to raise awareness.
  • Stimulate the advancement of research.


*(University of Ottawa Heart Institute, 2017)


Second Summit


The second edition of the Summit was held in April 2018. With the theme Le cœur dans tous ses états, its main objective was to focus “discussions on women's heart health at all stages of their lives” (Lachance, 2018).


Experts from around the world and women who have experienced heart disease gathered for the event with the aim of discussing strategies to address gaps in women's heart health. They also presented recent research findings, as well as exchanged views on scientific breakthroughs, prevention, treatment and recovery (Lachance, 2018).



Research Chair in Women's Heart Health


Quebec's first Research Chair in Women's Heart Health, awarded by the Heart and Stroke Foundation in collaboration with McGill University, was launched on July 1, 2019.


Led by Dr. Natalie Dayan, Assistant Professor in the Faculty of Medicine at McGill University and Director of Obstetrical Medicine in the Division of General Internal Medicine at the McGill University Health Centre (MUHC), the project aims to :

  • deepen our knowledge of the subject;
  • find ways to reduce the risk of heart disease and stroke; and
  • examine the benefits of breastfeeding immediately after childbirth.


Quebec center of expertise dedicated to women's cardiovascular health


In 2021, the Centre hospitalier de l'Université de Montréal (CHUM) has announced that it will fund the construction of the Centre cardio F, Quebec's first center of expertise dedicated to women's cardiovascular health.


Cardio F's mission is to overcome the lack of knowledge about the specificities of women's diagnoses. Through clinical research, the Centre aims to “better understand, improve, prevent, detect, cure and treat cardiovascular disease in women across their different life trajectories”. (Cardio F)


Risk factors specific to women

Did you know that the risks are much higher for women? That's because of the many physical and hormonal changes women undergo throughout their lives, such as pregnancy and menopause.


Between the ages of 12 and 50, her body produces estrogen, a hormone that protects her heart health, and so, in theory, this is the period when she is least at risk. However, certain oral contraceptives containing estrogen and progesterone can cause high blood pressure and form blood clots. These risks increase considerably if a woman smokes or already has high blood pressure.


During pregnancy, various health problems such as pre-eclampsia and diabetes can also disrupt cardiac well-being.


At the age of 50, generally at menopause, the risk of cardiac incident increases drastically due to the decrease in estrogen levels. This period is also often accompanied by an increase in cholesterol levels, blood pressure and fatty tissue, all of which increase the risk of heart disease (Heart and Stroke Foundation, n.d.).


Warning signs

Health professionals have found that many women show warning signs* of a heart attack weeks or even months before the event. They call these signs “atypical”, as few men report experiencing them.



Significant and unusual drop in energy level that does not subside after several days.


Sleep disturbance

Difficulty falling asleep or more frequent waking at night, usually due to discomfort or pain that prevents sleep.


Shortness of breath

Feeling of being out of breath after an ordinary activity, but especially during exertion.



Painful sensation of abdominal distension shortly after a meal, sometimes accompanied by pain or a burning sensation in the upper abdomen.


Chest pain

Mild discomfort that may also resemble indigestion.



Feeling of nervousness or fear for no apparent reason, or more frequent than usual.


*(Canadian Heart Health Centre for Women, n. d. (b))


Unfortunately, the under-representation of women in previous research on heart disease means that they have little awareness of its risks and symptoms. As a result, they don't seek medical attention and don't get the care they need quickly enough.


Many women tend to underestimate the importance of their symptoms, attributing them to daily stress and the busy pace of life with work, children and household chores. Some also think it's simply a digestive problem, the side-effects of a medication, or even that the symptoms will go away on their own.


Acute symptoms

Immediately prior to a heart attack, women generally experience chest pain, as do men. However, unlike men, they don't describe the pain as “stabbing”. Rather, it feels like a tugging sensation or pressure in the abdomen.


Here are the symptoms* that women generally experience just before an incident:



Significant and unusual drop in energy level that does not subside after several days.


Breathing difficulties

Breathing suddenly becomes very difficult and shallow.


Radiating pain

Pain spreads to the jaw, arm, shoulder and may extend to the back.


These symptoms are less frequent, but can also occur:


Cold sweats

Sudden sweating despite cool skin. Sometimes, the patient complains of sensations of heat or redness in the face.



Sickness for no apparent reason, sometimes accompanied by vomiting.



Feeling weak or dizzy.


*(Source: Canadian Women's Heart Health Centre, n. d. (b))


Obviously, symptoms vary from one woman to another, and do not necessarily all occur simultaneously. Some women experience some symptoms gradually, while others experience them all at once. Signs may appear and disappear over time, but it's vital to call 9-1-1 as soon as the first symptoms appear, or if you have any doubts.



In recent years, researchers have observed physiological differences between men's and women's hearts. Specifically, they have found that, in women, the heart and arteries are smaller and the heart rate is higher. Similarly, they noted that, unlike in men, the plaques that stick to the walls of the heart do not enlarge the arteries, but rather narrow them, thus promoting blood clot formation and obstruction.


As a result, tests to detect heart disease, based on the human heart, are imprecise. As a result, this variation influences diagnosis, treatment and, consequently, survival rates for women (Canadian Women's Heart Health Centre. n.d. (a))


In a nutshell,

Breaking down the misconception that heart disease is a man's problem is crucial to closing the gender gap in health care. Initiatives such as the Research Chair in Women's Heart Health are doing essential work to improve knowledge of the diagnosis and treatment of heart disease and stroke in women. Encouraging organizations and researchers who make this issue a priority will help save the lives of many women.



  • Agence QMI. October 28, 2021. “CHUM: a first center of expertise for women's cardiovascular health”. Journal de Montréal. [Last accessed 02/11/2022]
  • Canadian Women's Heart Health Centre. N.d. (a) “The difference”. University of Ottawa Heart Institute. [Last accessed 02/11/2022]
  • Canadian Women's Heart Health Centre. N.d. (b) “Female symptoms: an atypical heart attack”. University of Ottawa Heart Institute. [Last accessed 02/11/2022]
  • Heart and Stroke Foundation. N.d. “Women's Risk Factors”. [Last accessed 02/11/2022]
  • Government of Canada. 2009. “What are the symptoms of a heart attack in women?”. [Last consulted on 11/02/2022]
  • University of Ottawa Heart Institute. February 2020. “Canadians: on February 13, wear red for women's heart health”. The Beat.évrier-portons-du-rouge-pour-la-santé-cardiaque [Last accessed 02/11/2022]
  • University of Ottawa Heart Institute. N.d. “Prevention and wellness: gender”. [Last accessed 02/11/2022]
  • University of Ottawa Heart Institute. June 2017. “Charting the course for women's heart health in Canada”. The Beat.é-cardiaque-des-femmes-au-canada [Last accessed 02/11/2022]
  • Lachance, Judith. April 5, 2018. “Media Advisory: Canadian Women's Heart Health Summit”. University of Ottawa Heart Institute.é/avis-aux-médias-sommet-canadien-sur-la-santé-cardiaque-des-femmes [Last accessed 02/11/2022]
  • The Canadian Press. June 18, 2019. “Une première chaire sur la santé cardiaque des femmes au Québec”. La Presse. [Last accessed 02/11/2022]
  • Nedelman, M. February 14, 2017. “For decades, women had heart attacks in silence”. CNN Health. [Last accessed 02/11/2022]


Article written by Laurie Lévesque, content creator for Académie Saint-Bernard.

Edited and formatted by Émilie Bédard, communications manager.