Heart disease is the leading cause of death in women . . . killing more women than the next eight leading causes combined.

About nine million American women suffer from heart disease and nearly 250,000 women die from the disease every year. Heart disease in women may not be easily recognized, because women have different symptoms than men, says Dr. Janet Albers, associate professor of family and community medicine at SIU School of Medicine in Springfield. She describes the symptoms:

SOUND BITE: " . . . we so often have been taught -- you know the substernal chest pain, sweatiness and nausea, but in women the most common symptoms actually are fatigue and shortness of breath. And so if we can make women more aware of those symptoms and check them early on, so we can with appropriate testing, prevent heart attack and heart disease."

Women have increased risk of heart disease if they have diabetes, high blood pressure and high cholesterol. Family history, smoking, and being overweight are also risk factors. Post-menopausal women have a higher risk for the disease than pre-menopausal women says Dr. Albers.

SOUND BITE: "Women are protected by estrogen through the time of menopause, so our time for developing heart symptoms is pushed out a little bit later than men, again having it maybe in their 40s, 50s, 60s, women tend to be 60s, 70s, 80s when they develop symptoms. And women when they develop heart symptoms, often their first symptom is a heart attack, unfortunately."

Women can lessen their risk of having a heart attack by having routine physical examinations by a primary care physician. They should keep their blood sugar, blood pressure and cholesterol levels and weight in check. And they need to stop smoking to improve their heart health.