Pressure on your chest, pain in your left arm: these are the signals that people often associate with a heart attack. But these are symptoms that often belong to the male heart. With the woman’s heart it is a different story.
Cardiologist Janneke Wittekoek (54) has made it her life’s mission to better inform women about their hearts. She wrote it all down in her latest book The Woman’s Heartto reduce cardiovascular disease. But also to make women more aware and empowered, so that the medical world also follows suit.
Cardiovascular disease is the number one cause of death worldwide in both men and women. But when Wittekoek was still training to become a cardiologist, she noticed that women with heart problems were all too often sent home in the emergency room. “We could not make a clear diagnosis at the time. But why did they have complaints?”
Wittekoek explains that these women often had pain between the shoulder blades and unexplained chest pain. “I realized that we had to look at women differently in order to understand their complaints and give them a good diagnosis. It is quite difficult to question the approach to heart complaints within hospital walls and existing protocols and to state that a woman’s heart may become ill differently. The existing protocols are largely based on the male body. Approaching women’s hearts differently does not fit within those protocols and to this day I am not always appreciated.”
Janneke Wittekoek writes the book Het Vrouwenhart
So Wittekoek decided to inform women about the important differences, partly with this book. “Are my complaints coming from the heart? Which risk factors play a role in me? What role do my hormones play?” These are questions that women want answered, according to the cardiologist. She explains that a lot of knowledge about the female heart is often based on American research. “They are way ahead when it comes to women’s medicine. In this way, I hope to help reduce cardiovascular disease and make women more aware of their heart health.”
According to the cardiologist, 80 percent of cardiovascular disease in men and women is the result of an incorrect lifestyle. “If women know how their heart works and what the typical symptoms of heart problems are, they will be more likely to sound the alarm and go to the doctor. I also provide a lot of information about what women can do themselves to prevent heart disease.”
Difference between men’s and women’s hearts
Because the women’s and men’s hearts have important differences. “Men often have classic heart complaints. Pressure in the chest during exertion, radiating to the left arm and jaw. This is the result of an almost clogged blood vessel. Women, on the other hand, can also experience other complaints. This does not necessarily have to happen during exertion, but can also occur at rest. They feel as if their bra is too tight and have pain between the shoulder blades,” Wittekoek explains.
“In women you often do not see one clogged blood vessel as in men, but a small amount of arteriosclerosis in all vessels. The small blood vessels can no longer function properly and become cramped. You cannot angioplasty small blood vessels, which means you are more dependent on medication and lifestyle. Malfunctioning of the small vessels is an important alarm signal and must be treated properly. Do you not recognize the complaints and risk factors? Then a woman can have a heart attack within three years.” Did you know that heart attacks are most common on this day?
Stress is apparently a real culprit for women’s hearts. “More attention should be paid to this in the consultation room. Just like the relationship between heart and head. A woman’s heart is simply more sensitive to stress. Partly due to our busy living environment and 24-hour economy, we are chronically exposed to stimuli. These stimuli, such as too many apps, appointments and social media, affect our heart. Much more attention needs to be paid to the relationship between the living environment, with all its techno-stress, and our heart health.”
Lifestyle and mental state
As Wittekoek said before, the vast majority of heart health has to do with our lifestyle. “That’s not just food. But also exercise, stress and relaxation. My motto now is: Know your numbers.” Numbers? “Yes, how many hours do you exercise? How much do you eat? How much do you weigh? Do you smoke? Do you drink? What is your cholesterol? What is your blood pressure? What is your blood sugar level? And how do you sleep?”
In addition, the cardiologist also emphasizes the importance of the mental state. “Are you under a lot of stress? Due to work, your relationship or social pressure? Then balance is important. Yoga, mindfulness or meditation are all ways to positively influence your nervous system. But the most important thing is that we keep moving. We can never incorporate movement into a medicine. If you exercise for 20 minutes every day, for example by walking, you will see that your mental state, blood pressure and cholesterol improve.”
When it comes to nutrition, Wittekoek advocates the 80/20 rule. In other words, 80 percent healthy and 20 percent for enjoyment. “If you thoroughly enjoy a pink cake, then that should be possible. But we really don’t eat enough vegetables these days. I am a fan of intermittent fasting myself. This teaches you to eat mindfully. But intermittent fasting is not for everyone.”
Stress is disastrous for women’s hearts
Coming back to that stress and that woman’s heart. Because, according to Wittekoek, that is something to really think about. “A person can handle a little stress. For example, exercising creates a physical stress stimulus. But we see that as healthy stress. It’s much more about chronic stress. Do you lead a very busy life? Then relaxation and sleep are essential. In any case, losing your sleep is disastrous for the heart. But it’s about that mental balance. Do you not have your head in order? Then you also see that you are more likely to eat unhealthy food, not exercise enough and choose an unhealthy life. So it really all starts with that head.”
Wittekoek explains that, for example, pent-up emotions have a bad influence on a woman’s heart. “It has been proven that a continuous stress stimulus ensures that our immune system gets to work. If that becomes depleted, you increase the risk of inflammation and heart problems. You can feel stress and sadness in your heart.”
The cardiologist also sees women in her consultation room with heart complaints as a result of intense emotions. In its most severe form, this can lead to ‘broken heart syndrome.’ A rare condition caused by an intense emotional event. Such as a relationship break-up or the loss of a loved one. “The extremely intense startle response can result in serious heart failure. As a result, you must be acutely admitted to hospital for treatment with medication. 90 percent of ‘broken heart syndrome’ cases involve women.”
Making your body and brain stronger
According to Wittekoek, a healthy lifestyle and balance keeps your heart and blood vessels healthy. “But maintaining a good relationship with your family, partner and friends is also important. That can really be a big culprit for a woman’s heart. Because if you improve your own resilience, you can also deal with setbacks better. You therefore have to make your body, but also your brain, stronger.”
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