Selected Podcast

Women and Heart Disease

Amy O'Neil, DO, discusses who is most at risk for heart disease, signs and symptoms of a heart attack, and how these symptoms might differ in women and men. She also shares some of the advancements in cardiac care.

In the interview, Dr. O'Neil answers the following:

1) Heart disease has a major impact on our country, and in most communities it’s still the number one killer of adults. Who’s at greatest risk for heart disease?
2) What are the signs and symptoms of a heart attack?
3) Are those symptoms different in women?
4) The American Heart Association says heart disease may be preventable. Can you talk about the impact of heredity and lifestyle as they relate to heart disease?
5) Compared to 20 years ago, there are many new treatments and procedures to improve quality of life--or save the life--of someone living with heart disease. Can you talk about a few of the advancements in cardiology care?
Women and Heart Disease
Amy O’Neil, DO
Dr. Amy O'Neil is a board certified cardiologist and is now serving patients in the Waterford. Dr. O'Neil graduated from Michigan State University College of Osteopathic Medicine in East Lansing, MI.  She completed her internal medicine residency training and cardiology fellowship at Garden City Hospital in Garden City, MI. 

Learn more about Amy O’Neil, DO

Bill Klaproth (Host):   Heart disease is the leading cause of death for both men and women. However, because of long standing misconceptions about this decision, many women are at a higher risk because the symptoms of heart disease can be different in women and men. So let’s learn more with Dr. Amy O’Neil, a cardiologist at McLaren Health. This is McLaren’s In Good Health. I'm Bill Klaproth. Dr. O’Neil, heart disease has a major impact on our country. In most communities, as I mentioned, it’s still the number one killer of adults. So in general who is at greatest risk for heart disease?

Amy O’Neil D.O. (Guest):   So people who are generally at greater risk are patients with several risk factors for heart disease. The major preventable risk factors include high blood pressure. Patients with diabetes, people who smoke or use other forms of tobacco, people who are overweight and have a more sedentary lifestyle, people who don’t exercise on a regular basis, consuming high fat diets, diets high in red meats. Then there's, of course, family history and hereditary factors. Interestingly about 80% of heart disease is caused by a preventable factor. So there's several interventions and lifestyle changes that people can make to decrease their chance of having a heart attack.

Host:   Wow. That is an interesting stat. You just said 80% of heart disease is caused by preventable factors, and you just listed them out. High blood pressure, diabetes, people that smoke, people that are overweight, people that lead a sedentary lifestyle. So lifestyle is a huge contributing factor of this. Let’s talk about that coming up, but first let me ask you about the signs and symptoms of a heart attack. What should we be looking for?

Dr. O’Neil:  So the typical classic symptoms we say are chest pain, specifically a chest pressure. Some people describe that as an elephant sitting on their chest. Sometimes arm pain, shortness of breath, symptoms that get worse with activity and then get better if the patient sits and rests. There's more atypical symptoms not as common like nausea or vomiting sometimes. People have that as well.

Host:   Well that’s a good list to remember. Chest pain, arm pain, shortness of breath, symptoms worsening with activity, even nausea. So now let’s talk about the symptoms in women. How are those different than the symptoms that men would feel?

Dr. O’Neil:  So women are less likely to have those typical classic symptoms of the chest pressure. Sometimes they can have symptoms of feeling lightheaded, general tiredness, just not feeling right, not feeling themselves. They can get jaw pain. We’re still doing so much research why heart disease presents differently in women. Some things that we have found is that potentially hormones can be involved and can cause almost a spasm of the arteries and can cause disease in the walls of the arteries that was different than in men. So we’re doing further research to try to find out what we can do specifically for women with heart disease.

Host:   Right. So in addition to the symptoms that we all would feel—chest pain, arm pain, shortness of breath as you said, symptoms worsening with activity—women need to pay attention to, as you said, jaw pain.

Dr. O’Neil: Yes.

Host:   An overall feeling of just tiredness. Really like drained. Is that kind of what you're saying?

Dr. O’Neil:  Yeah. It’s feeling really tired and fatigued and just a change in their overall health and feeling.

Host:   Well, I think it’s really good for women to understand the differences in the symptoms between men and women. You mentioned hereditary factors earlier. Let’s talk about that for a quick second. So for someone with heart disease in their family, how should they approach this?

Dr. O’Neil:  So if somebody does have a significant family history of heart disease, they should come to their doctor much earlier. In their 30s start really paying more attention to any heart symptoms and their lifestyle as well.

Host:   Well, that would make sense. So somebody that does have a history of heart disease in their family, they really have to pay attention to the lifestyle factors.

Dr. O’Neil:  Yes, very much. We see in patients with hereditary factors, we can see them developing significant heart disease as early as 40 years old.

Host:   So compared to 20 years ago, there are many new treatments and procedures to improve the quality of life or even save the life of someone living with heart disease. Can you talk about a few of the advancements in cardiology care?

Dr. O’Neil:  So we’ve had quite a few advancements in patients who have heart failure from heart disease. So we have several new medications that can help not only their quality of life but can help them to live longer. There are also surgical devices that can be put in patients with advanced heart failure that can prolong their life and help them live a better quality of life. We also have more monitoring where we can detect changes in the patient’s bodies before they start to develop symptoms of heart failure. So we can make adjustments to medications before they end up having to go to the hospital.

Host:   So it’s certainly good to know about these advancements to help not only in discovering heart disease but also in treating heart disease as well. So earlier we were talking about lifestyle factors, these preventable factors that can help you not get heart disease. I want to get back to that as we wrap up. We hear this term “know your numbers”. So you had given us a great list of things we should watch out for. One of them was high blood pressure, another was diabetes. So high blood pressure, diabetes, and a glucose number. So what are the important numbers that we should know to help us prevent heart disease?

Dr. O’Neil: So for blood pressure, the recommendations now state that blood pressure less than 130 over 80 is the ideal goal. So maintain a blood pressure of less than 130 over 80 is what we live to see. We often times recommend the patients take their blood pressure at home so that we know what their blood pressure runs on a daily basis. Then cholesterol is another very important factor in preventing heart disease. Ideally we want the so called bad cholesterol to be less than 100. If you're diabetic and you have diabetes, less than 70. So those are some important goals. Diabetic patients should try to control their hemoglobin A1C levels less than 6.5. All of these things can help decrease the chance of developing heart disease and heart attacks.

Host:   Right. So do we consider that—when you were talking about diabetes—is that our blood sugar level?

Dr. O’Neil:  So hemoglobin A1C is a blood test that measures essentially the average blood sugar over three months. So it’s not a glucose blood sugar, like a real time number, but an average.

Host:   So, there you go. Three easy numbers that you should know at all times your blood pressure, your cholesterol, and your blood sugar levels. Dr. O’Neil, this has been great and very informative. Thank you so much for your time.

Dr. O’Neil:  Yes, thank you so much. It was great talking with you.

Host:   That’s Dr. Amy O’Neil, a cardiologist with McLaren Health. To learn more about Dr. O'Neil or submit a question visit You can also visit If you found this podcast helpful, please share it on your social channels and check out the full podcast library for topics of interest to you. This is McLaren’s In Good Health. Thanks for listening.