How Women Miss Heart Attack Warning Signs

Lessie was in her mid-sixties when she awoke one night with a strange feeling. It was something she had never felt before.

“It felt as though an elephant was sitting on my chest,” she said. “I couldn’t catch my breath.”

She wasn’t sure what was wrong as she arrived at the local emergency room, but it certainly never occurred to her that it might be her heart. Within hours, she was undergoing heart bypass surgery.

“The doctor told me that if they didn’t operate right away, I would have a heart attack in the next day or two and it would likely be fatal,” Lessie said.

Lessie’s story is an all too familiar one with heart specialists. They know heart disease is the number one killer of women in this country. They also know that many women miss the early warning signs or wait to seek medical attention, which can be a fatal mistake.

All Heart Attacks Are Not Created Equal

The fact is heart attacks present differently in women than men said Dr. Robin Germany, a cardiologist with OU Physicians and an assistant professor of medicine at the University of Oklahoma Health Sciences Center.

“Some women will get the traditional chest pain with pain radiating down the arm,” said Germany. “However, many more have much more subtle symptoms. They may simply feel nauseous, tired or short of breath. They may also experience pain in their jaw or back. All of these can be warning signs of a problem with the heart.”

Because women may miss the early warning signs of heart trouble or dismiss them as something else, care is often delayed. Germany explained early treatment is important in men and women, but most important in women. She pointed out while the death rate from cardiovascular disease in men is dropping, it is increasing in women.

“The fact is because women are generally smaller than men and their blood vessels are smaller, surgeons face additional challenges with traditional treatments for blockages like balloon angioplasty, stents and bypass surgery,” she said, “They only make many of the devices we use so small and in many instances the smallest device may still be too large for a woman’s blood vessels. So women’s outcomes are often worse than men’s.”

Germany added that it is why it is much better to try to catch heart disease in women at its very earliest stages when they are more likely to respond well to lifestyle changes like diet and exercise or medical therapies like blood thinners.

Post-Menopausal Women at High Risk

According to Germany, women appear to have some sort of innate protection from heart disease until they reach menopause. “It used to be thought it was estrogen that provided that protection. Studies now show it is not estrogen, but there is something that protects women in those pre-menopausal years,” she said.

The fact is women tend to suffer heart attacks about ten years later than men. Somewhere around the age of 65, women begin to catch up with men in terms of the number of heart attacks and surpass them in terms of deaths from heart attacks. Complicating the picture are the other health problems women may develop with age. 

“When women have multiple health issues, such as diabetes, kidney or bleeding problems, diagnosing heart disease can be more difficult,” Germany said. “Because the symptoms of heart disease in women can also be very vague, women may have a tendency to write them off as something else. A woman who is having a lot of nausea and feeling tired may go to her regular physician because she thinks she has the flu. An EKG would tell them right away that it’s her heart and not the flu, but a doctor may not think to do that test.” 

Protecting a Woman’s Heart

There are things that women can do to help protect themselves from heart disease even after menopause. Germany said eliminating smoking tops the list.

“So many women who smoke will say ‘I know it can give me lung cancer,’ but what they don’t realize is that smoking is just as damaging to their hearts, if not more so,” she explained. 

High blood pressure is another area that women need to work to control. Germany said there are women who live with slightly elevated blood pressure for years who are surprised when they are diagnosed with heart damage. She pointed out that even blood pressure that is only slightly high causes damage to the heart.

“Women need to know what normal blood pressure is and then make sure they do the things they need to do in terms of diet, exercise and medications to maintain normal blood pressure,” she stressed.

Germany added that women also need to try to be more active each and every day, calling exercise a “God-made bypass” because it can help clear the cardiovascular system. “Find the time to be active,” she said. “It doesn’t have to be a lot of time or even all at once. We’re talking about 30-minutes each and every day. Spend 15 minutes of time walking during your lunch break or take a brisk walk after dinner. It all adds up to a healthier heart and a healthier you.”

Finally, Germany said women need to begin to take care of themselves as well as they take care of their husbands and families.

“If something is not quite right, don’t ignore it,” urged Germany. “See your doctor right away. It’s always better to take care of little problems as they crop up than to wait for a big problem to materialize.”