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What causes coronary artery disease and heart attacks in women?

Hardening of the arteries, or atherosclerosis, can cause coronary artery disease and heart attacks in both men and women.

Atherosclerosis causes fatty deposits called plaque (say "plak") to build up inside coronary arteries. These arteries provide blood and oxygen to the heart muscle. In most people, this plaque builds up so much that it can narrow the arteries and limit blood flow. Limited blood flow can cause angina symptoms, such as chest pain or pressure. A heart attack occurs when not enough blood and oxygen reach the heart muscle.

But for some women, the way that coronary artery disease and heart attacks happen seems to be a little different. For example, women are more likely to have:

  • Non-obstructive coronary artery disease - In many women, plaque does not build up so much that it narrows arteries and blocks (obstructs) the blood flow. This is often called non-obstructive coronary artery disease. It can still cause symptoms, such as chest pain or pressure, and lead to a heart attack.
  • Microvascular coronary disease - With this disease, tiny blood vessels of the heart are damaged. These blood vessels carry blood from the coronary arteries into the heart muscle. If they suddenly contract, or spasm, the heart muscle gets less blood and oxygen. This can cause angina symptoms, like chest pain or pressure, and even a heart attack.
  • Less common causes of heart attacks - In most people, a heart attack happens when a plaque breaks open and a blood clot blocks blood flow in a coronary artery. But women are more likely to have heart attacks that are caused by other things. For example, a spasm in a coronary artery can block blood flow and cause a heart attack. Or a sudden tear in a coronary artery, called a spontaneous coronary artery dissection (SCAD), can cause a heart attack.

Women and Heart Disease

MaineHealth helps heart patients receive the care they need to live longer, healthier lives. Our highly-skilled cardiac and vascular specialists see patients at community hospitals across Maine and parts of New Hampshire. Often, heart care can happen close to home.

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