The myth still persists that heart attacks are a men's health problem, but a new scientific statement from the American Heart Association says cardiovascular disease is the No. 1 killer of women worldwide.

This is the first time the association has addressed this specifically as a women's issue, says the Calgary Eyeopener's medical contributor, Dr. Raj Bhardwaj, a Calgary urgent care and family physician.

MORE CALGARY NEWS | Radar testing accurate, say Calgary police after CBC News probe

MORE CALGARY NEWS | High River criticizes Disaster Recovery Program as 2013 flood claims remain unresolved

There are a couple of big takeaways from the association's statement, says Bhardwaj, including that symptoms and risk factors for heart disease are very different for women than men.

Dr. Raj Bhardwaj

Dr. Raj Bhardwaj (@RajBhardwajMD/Twitter)

"Normally, heart attacks are due to a "pipe getting clogged," says Bhardwaj. That still applies to women but the key difference is that among women it's more common for the pipe to rupture or split.

That's just one of several differences between men and women, the report found.

Bhardwaj uses the "typical Hollywood heart attack" analogy to point out another difference. A man clutches his chest, has pain radiating down his left arm and into his jaw and he's sweaty and pale. "That's very typically a man's heart attack."

Atypical heart attack symptoms

About 20 per cent of women will have no chest pain when they're having a heart attack. But other symptoms will happen that may be confusing to them — and even for the doctors and nurses who may be treating them.

Still, Bhardwaj says, 80 per cent of women will have chest pain as a symptom, whereas that occurs in more than 90 per cent of men.

But women's heart attack symptoms can include:

  • Shoulder pain or ache (twice as common among women)

  • Sudden tiredness

  • Back pain

  • Indigestion

  • Feeling of dread

Some of these lesser known symptoms, can be problematic for women seeking medical attention.

Delay seeking medical help 

"A lot of the time women will go to the emergency room saying, ' I'm having this weird back pain, and I'm feeling really, really tired,' and the doctors and nurses...won't think of heart attack as even a possibility sometimes."

Bhardwaj says that can mean that women won't fare as well when they have a heart attack.

"They don't recognize the symptoms so they delay going to see a doctor. And … even when they get to emergency, the doctors and nurses might not twig to that because we're so focused on back pain or the tiredness, or a feeling of dread, which is very common."

Another interesting finding is that the usual suspects, heart attack risk factors such a smoking, high blood pressure, diabetes, being overweight and sedentary and having high cholesterol, are all key heart attack indicators for both men and women.

But it appears some of these factors present bigger risks for women, namely, smoking and high blood pressure, while being overweight and developing diabetes is a significant risk for younger women. But cholesterol doesn't seem to play as big a role, especially over the age of 65 for women.

Meanwhile, another emerging factor for women is stress and depression.

It all points to the fact that more research needs to be done on women's health issues, says Bhardwaj. "We need a lot more research on women, that's not just in heart attacks."