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Overlap Between Heart Failure and Menopause: Diagnostic Challenges and Clinical Implications
Timothy Nathan Kwan1, Aimy Yan1, Pankaj Jain1
1Department of Cardiology, Concord Hospital, The University of Sydney, Concord, NSW, Australia.
Heart, Lung & Circulation
|July 16, 2026
Summary
Menopause and heart failure often overlap in middle-aged women, complicating diagnosis. Recognizing shared symptoms like fatigue and shortness of breath is crucial for timely heart failure identification and treatment.
Area of Science:
- Cardiology
- Endocrinology
- Women's Health
Background:
- Heart failure and menopause frequently coexist in middle-aged women.
- Menopausal hormonal changes, particularly estrogen decline, may contribute to cardiac dysfunction and fibrosis.
- Ageing and menopause-induced physiological shifts increase cardiovascular disease risk.
Purpose of the Study:
- To review the intersection of menopause and heart failure.
- To elucidate shared pathophysiological mechanisms.
- To propose strategies for improving diagnosis and treatment in perimenopausal women.
Main Methods:
- Literature synthesis of current evidence.
- Analysis of epidemiological data on menopause and heart failure risk.
- Review of diagnostic tools and therapeutic guidelines.
Main Results:
- Estrogen decline is linked to myocardial fibrosis and diastolic dysfunction.
- Early menopause is an independent predictor of incident heart failure.
- Common menopausal symptoms can mask underlying cardiac pathology.
Conclusions:
- Heightened awareness of symptom overlap is essential for accurate diagnosis.
- Objective investigations (e.g., natriuretic peptides, echocardiography) are reliable.
- Guideline-directed therapies can be used independently for heart failure and menopause management.
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