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Oct 20, 2011

Heart Attack in Women without Heart Disease

Study explores the causes heart attacks in otherwise healthy women.

Coronary artery disease (also called coronary heart disease or heart disease) is a term used to describe the narrowing of the arteries inside the heart due to the build up of plaque, known as atherosclerosis. The build up of plaque occurs over many years and can vary in severity. For example, some patients may have significant build up of plaque that blocks more than half of the coronary arteries, known as obstructive coronary artery disease. Others may have very little plaque build up, leaving their arteries very wide and allowing for ample oxygen-rich blood flow.

Overall, researchers have found that most heart attacks occur in patients with significant build-up of plaque, such as those diagnosed with obstructive coronary artery disease. That’s because when plaque builds up in the arteries, it can slow or block the flow of blood and oxygen, causing a heart attack. However, researchers have noticed an exception, where some adults without heart disease or the build-up of plaque suffer heart attacks. This occurs in about one-third of women and 12% of men that have heart attacks. Unfortunately, little is known about the cause and prevention of heart attacks in otherwise healthy patients, but continued research has helped shed some light on this matter.

A study published in Circulation, an American Heart Association medical journal, recently helped to identify the possible mechanisms causing heart attack in women without heart disease. Out of 121 women identified with a history of heart attack for this study, 50 were eligible and received two important types of tests to evaluate cardiovascular health — intravascular ultrasound (IVUS) and cardiac magnetic resonance imaging (CMR). Using these tools, researchers were able to find that while 30% of women had completely normal arteries with no excess plaque build-up, many had plaque disruption and/or rupture. Plaque disruption and ruptures can trigger the formation of clots, which can sometimes block arteries and cause heart attacks.

This study helps to confirm what researchers have long hypothesized — that a variety of common conditions exist among women with a history of heart attack and no heart disease, such as plaque rupture, ulceration and inflammation. It also helps demonstrate that the combination of two tests, IVUS and CMR, are extremely useful in helping to assess the cardiovascular health of heart attack patients. Although additional research is needed to better understand the exact mechanisms causing heart attacks in women without heart disease, findings will prove extremely useful in guiding future studies and ultimately furthering knowledge around prevention.

Questions for You to Consider

  • Who is at risk for heart attack?
  • The most common risk factors for heart attack include increased age, tobacco use, diabetes, high blood pressure, high cholesterol, obesity, stress, illegal drug use, lack of physical activity and family history of heart attack.
  • How does heart attack risk differ in men and women?
  • Although risk factors for heart attack are similar among men and women, women are more likely to have more serious heart attacks, resulting in death. Women also tend to experience atypical symptoms of heart attack, such as abdominal pain, heartburn, clammy skin, dizziness and fatigue. It is important to call 9-1-1 at the first sign of either typical or atypical heart attack symptoms to seek immediate medical attention.


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