Women's Heart Disease: Why Symptoms Get Missed and What Menopause Changes | Dr. Suzanne Steinbaum

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Heart disease kills more women than all cancers combined, yet many women still consider breast cancer their greatest health threat. Why is the leading cause of death among women so frequently overlooked? Dr. Taz welcomes preventive cardiologist and women's heart health advocate Dr. Suzanne Steinbaum to explore why cardiovascular disease remains underrecognized in women, how symptoms can be missed or dismissed, and what women need to know to protect their hearts.

Drawing on more than two decades of experience in preventive cardiology, Dr. Steinbaum shares the patient encounter that changed the direction of her career: a 53-year-old woman whose symptoms were initially diagnosed as a stomach illness before she suffered a heart attack. She explains how decades of cardiovascular research focused primarily on men have contributed to gaps in understanding women's heart disease, and why conventional risk assessments may not capture the full picture.

Their conversation explores how heart disease can develop differently in women, particularly in the smaller blood vessels of the heart. Dr. Steinbaum explains coronary microvascular disease, why symptoms such as chest discomfort, palpitations, and shortness of breath may be mistaken for anxiety, and how certain cardiovascular conditions can be difficult to detect through conventional testing. They also discuss emerging diagnostic technologies, including AI-assisted coronary CT imaging, and the importance of looking beyond standard cholesterol numbers.

Dr. Taz and Dr. Steinbaum examine the connection between menopause, declining estrogen, and cardiovascular health. As women transition through perimenopause and menopause, changes in cholesterol, insulin resistance, and blood vessel function can influence their risk. They discuss why hormone therapy alone is not necessarily the answer, and how pregnancy complications, autoimmune conditions, family history, and inflammation can provide important clues about a woman's cardiovascular health.

The conversation also turns to chronic stress and the invisible load many women carry. Dr. Taz shares her husband's experience of having a heart attack at 41, while Dr. Steinbaum explains how stress hormones can influence blood pressure, inflammation, and arterial function. Together, they explore why high-achieving women often normalize exhaustion and physical symptoms, the importance of managing stress, and how practices such as meditation and movement may support cardiovascular well-being.

Dr. Steinbaum offers practical guidance on becoming a better advocate for your heart health, including which risk factors to discuss with your doctor, when further evaluation may be appropriate, and why cardiovascular exercise remains essential alongside strength training. Her message is that protecting your heart starts with understanding your personal health history, recognizing changes in your body, and taking an active role in prevention.

IN THIS EPISODE

• Why heart disease remains the leading cause of death among women
• How decades of male-focused cardiovascular research have affected women's care
• The differences between heart disease in men and women
• Why women's heart symptoms can be mistaken for anxiety
• Coronary microvascular disease and why it can be difficult to detect
• The limitations of conventional heart screenings and risk assessments
• How menopause and declining estrogen affect cholesterol, metabolism, and arterial health
• Pregnancy complications, autoimmune conditions, and other ov