| "What women really need to focus on are sudden changes in symptoms which are persistent over the course of a month." | One out of two. If you're a woman, those are your chances of dying from heart disease or stroke. Your odds of dying from breast cancer are one in 27. Studies have shown repeatedly that women fear dying from breast cancer more than heart disease, even though heart disease has been the leading killer of women for decades. And, more than ever, it doesn't necessarily happen at a ripe old age. Cardiovascular diseases affect more women than men and heart attacks are generally more severe in women than in men. In the first year after a heart attack, women are more than 50 percent more likely to die than men – especially young women. In the first six years after a heart attack, women are almost twice as likely to have a second heart attack. Failing to recognize and respond to symptoms of a heart attack may be one reason women experience a greater proportion of sudden cardiac deaths than men. More than half of all cardiac deaths in women occur outside of a hospital. Over the last decade, the incidence of sudden cardiac death in women 35 to 44 years of age has increased more than 20 percent. So what's the problem? Mostly misperceptions, among women as well as their doctors. The current warning signs of a heart attack are based primarily on studies of white, middle-aged men. While the signs are important to know, researchers have speculated that adhering too rigidly to this list contributes to misunderstandings in clinicians as well as the lay public. They also suggest it leads to inaccurate diagnoses and cause women to delay seeking treatment. Heart Attack Warning Signs - pressure, fullness, tightness or pain in your chest lasting five minutes or longer
- constant indigestion-like discomfort
- chest pain that moves to your shoulders, arms, neck, jaw or back
- lightheadedness, dizziness, fainting, sweating or a sick stomach
- unexplained shortness of breath
- unexplained anxiety, weakness or tiredness
- palpitations, a cold sweat or paleness
"Traditionally, cardiovascular studies have focused on men, even though women have a higher prevalence of heart disease, especially as they age. But more and more we're finding that men and women experience heart disease very differently," says Dr. Frank Smart, a cardiologist and director of Advanced Heart Failure/Cardiac Transplantation at the Texas Heart Institute and St. Luke's Episcopal Hospital. "Physicians need to take women's health complaints seriously and understand that not all the guidelines apply to women, whose symptoms may appear more non-specific to heart disease," says Dr. Smart. "It's important for women to have a good working relationship with their doctor and be aware of their own risk factors for heart disease." A recent study sheds new light on just how differently women experience heart attack compared to men. A survey of more than 500 women found that 95 percent had specifically new and different symptoms up to a month prior to their heart attacks. Surprisingly, fatigue and problems sleeping top the list. More than 70 percent of the patients experienced no chest discomfort, as most men do.
Most Common Symptoms Reported by Women in a Month Prior to a Heart Attack: - 71% unexplained or unusual fatigue
- 48% sleep disturbance
- 42% shortness of breath
- 39% indigestion
- 35% anxiety
"Obviously, looking at the survey results, these are symptoms that women could easily wave off as being signs of stress or aging or simply the result of having a very busy lifestyle. This study should serve as a red flag for women to pay attention to their bodies and look for trends, particularly women with known risk factors," says Dr. Smart. The risk factors among the study group are significant in that 96 percent had a family history of heart disease, 62 percent had a personal history of heart disease and 33 percent had diabetes. "What women really need to focus on are sudden changes in symptoms which are persistent over the course of a month. The women in this study described their fatigue and sleeplessness as severe; for example, being unable to make the bed without resting," explains Dr. Smart. How women respond to these symptoms could mean the difference between life and death. In the study, some of the women ignored their symptoms whereas others repeatedly sought medical care only to have their doctors minimize, misdiagnose or ignore their symptoms.  Dr. George Reul, above, was noted as a "top doc" by Good Housekeeping magazine which listed the Texas Heart Institute at St. Luke's Episcopal Hospital as one of the leading cardiac centers for women. | The symptoms women described at the time of their heart attacks are also interesting. Nearly 58 percent had shortness of breath, 55 percent experienced weakness, 43 percent felt fatigue, 39 percent broke into a cold sweat and 39 percent had dizziness. Notably, 43 percent of the women experienced no chest pain. Of those that did, they described the discomfort as pressure, aching or tightness – not pain – and it mostly occurred in the back and high chest. "The key here is to be aware of all the warning signs. Anyone who has any of these signs for five minutes or longer should see a doctor right away. And patients should be assertive in their care. There was a small study a couple of years ago among emergency and critical care clinicians in which 85 percent of nurses and 66 percent of doctors said they assessed primarily for pain in persons suspected of having a heart attack, even though almost all of them had previous experience with heart attack patients who had atypical symptoms." says Dr. Smart. "The bottom line is if there is a sudden change in symptoms and you're just not feeling right, go to the doctor." Return to Stories from the Heart main page. |
