Why does a woman’s heart skip a beat?

On World Heart Day, doctors advise Indian men to have a heart and look after their wives  Empowerment at the price of a healthy heart? More Indian women than ever before are joining the workforce, their hearts are skipping more than just a beat and it's not always because of a man. It's part of the global picture, which has women accounting for 15-20% of heart disease.      Dr Ashok Seth, chairman of Delhi's Escorts Hospital, says, modern women face more stress than their mothers and grandmothers. "More of them are coping with high-pressure jobs, and also looking after their homes, giving them heart disease 10 years earlier." Seth warns women to "pay more attention to themselves" because heart disease is likely to be the number one killer within five years.      Doctors agree heart disease afflicts women at least a decade before they could expect it. Earlier, it would strike women over 60, but now, it's hitting them at 50, says Dr Praveen Chandra, director of Cardiac Cath Lab of Delhi's Max Hospital.      Stress is often compounded by neglect. Dr Kushagra Kataria, CEO and chief cardiothoracic surgeon of Gurgaon's Artemis Hospital says it is very noticeable "that when women come in with their sick husbands, they wait till they have get treated first and then tell me they too have the same symptoms." Perhaps the best advice for Indian men on World Heart Day should be 'Have a heart' and look after your women.      Do they face the same risks? Women initially have the advantage because the female hormone, estrogen, protects the heart. But menopausal women have declining estrogen levels and the risk equals that of men, say cardiologists. Women who pop the pill are more at risk because oral contraceptives are thought to increase the risk of blood clots, says Chandra.  The changing mindset of the Indian woman means the rise of what Kataria calls "the Type A" personality (aggressive, ambitious, impatient), often seen in men. Type As are more prone to heart disease.  Most scary is women exhibiting atypical symptoms of an attack. Seth says "women may not always show typical angina symptoms, but could just suffer from breathlessness." He adds this "is often dismissed as lack of fitness. Their treadmill exercise test too shows greater negative results."  Women need to know that the pain preceding a heart attack could be just about anywhere – the upper arms, shoulder, back, jaws, tooth, groin, head, adds Kataria. This, because the heart itself has no nerves but the outer membrane does and "when the heart is deprived of oxygen during an attack, these nerves send out signals to nerves elsewhere and the pain manifests itself in any of these areas."      But the heart of the matter is that women respond worse to angioplasty and bypass, says Seth, probably due to their smaller arteries. Chandra adds that a woman generally has a more severe heart attack than a man, so it is more likely to be fatal.  FOR A SAFE HEART  Have a check-up once you're over 30, or if you have a family history of heart disease  Check your cholesterol and sugar levels and have a Treadmill Exercise Test  Breathlessness and indigestion, which is unrelieved by medicine, could be symptoms