Let’s Talk About Sex

One of my patients recently asked me whether men or women fare worse when it comes to heart disease. My reply was, “It depends on which heart disease you are talking about.” Indeed, there are many different kinds of heart conditions and some do have sex-specific differences in demographics, prognosis, and treatment. I have been practicing clinical cardiac electrophysiology in Jacksonville area for more than 10 years. In this sub-specialty of cardiology, the main focus is managing patients with various types of electrical (rhythm) disorders. I would like to take this opportunity to summarize some important differences between women and men with respect to both the normal (physiologic) and abnormal (pathophysiologic) conditions of heart rhythm.
Women as a group have a slightly faster resting heart rate compared to men across all age groups. In addition, the time needed for heart cells to repolarize (electrically relax) after each heartbeat is slightly longer (by several milliseconds) in women than in men. This has an important implication with respect to an increased tendency for certain type of potentially life-threatening arrhythmia (rhythm disturbance) to affect women (discussed later). These and other subtle differences in electrical parameters are known to be the effect of female hormone estrogen. Male hormone testosterone has an opposite effect. I have described below several common arrhythmia conditions that I have encountered in my clinical practice that have distinct gender difference in prevalence.

 

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