A heart for women – Angela Maas

By putting women’s hearts on the map, ‘cardiofeminist‘ Angela Maas has saved many lives while fighting sexism in the medical field. As the pioneering professor in cardiology for women likes to say: “Men and women are equal, but when it comes to cardiovascular disease, treat her like a lady.“

Marlies: Your book ‘Heart for women’ was a total eye-opener for me. It is shocking that while heart disease is the leading cause of death for women, it is still largely diagnosed and treated as a ‘men’s disease’, using the male body – which is very different from a female body – as the norm. When did you realize that we’re dealing with a very dangerous type of sexism?

Angela: During the 1980s, I had learned in my cardiology training that women with chest pains were ‘weird’ and had strange and atypical symptoms. The easiest way out was to assume psychological distress. I had been a cardiologist for about 3 years when a completely fed-up female patient lost her patience and cried out: “Why can’t you explain to me what is wrong with me?” That really shook me and since then, I have dedicated myself to female-specific cardiology.

Marlies: What are the main differences between a male and a female heart?

Angela: Men suffer more often and at a relatively young age from blockages in their coronary arteries, something that can be treated very effectively with angioplasty or bypass surgery. It’s what medical science has always focused on. Due to hormones, women’s hearts work differently and our arteries narrow later in life. This happens under the influence of factors such as the menopause, high blood pressure during pregnancy and diabetes, and there are also different symptoms: pain in the jaws, the back or in between the shoulder blades. This narrowing is very tricky to spot in a standard cardiogram or exercise tolerance test, and women are sent home thinking they are deluded or must have done something wrong.

Marlies: And women already have a tendency to blame themselves…

Angela: Exactly. Just this morning, I consulted 7 women in a row who came to me for a second opinion after years of disregarded complaints. Most of them had been sent to a psychiatrist!

Marlies: How should we test women instead?

Angela: An effective way is to measure the spasms in the blood vessels that can lead to a heart attack. I have been pushing for this method for years, and now that we are finally implementing it, we are shocked at how often these spasms occur! We also see that women are getting heart attacks at a younger age, which is definitely related to our raised stress levels.

Marlies: Chronic stress causes inflammation, right?

Angela: Exactly. And inflammation, amongst other things, causes these spasms!

Marlies: What can women do to prevent coronary heart disease?

Angela: Besides genetic disposition, lifestyle is an important factor. Not only diet and exercise, but also stress-management; a real challenge in this achievement-oriented society. Take the influence of social media: everything has to be perfect, all the time. Unfortunately, women, with their perfectionist tendencies, seem especially susceptible to this type of pressure. And I can’t stress enough how bad smoking is, especially for women! Did you know that female smokers have literally twice the risk of a heart attack than male smokers?

Marlies: Wow, that proves again that there is no such thing as a ‘gender neutral‘ patient. Thanks for making us feel seen, Angela. You are saving our lives.

Read more about Angela’s ‘Heart for women’- foundation and book at www.hartvoorvrouwen.nl.