Recognizing Heart Attacks in Women

Q: One woman listener wrote in asking," How would I know if I were having a heart attack?"
We hear this question more frequently now, due to the aging baby boomer segment of our population and also because we now realize women often have a different presentation when experiencing a heart attack.

The classic symptoms we've heard for years indicating a possible heart attack are:

• Crushing or squeezing chest pain
• Tightness in the chest or shortness of breath
• Sweating
• Pain between the shoulders or pain that radiates to the arm or into the neck and jaw
• Feelings of heartburn or pain under the diaphragm
• Sudden loss of consciousness

However, we now know it's common for women to present with different symptoms. In fact, research by the National Institute of Health noted that just over 40% reported no chest pain during any phase of a heart attack. Consider that most doctors rely upon chest pain to be the most important presenting symptom in both men and women and you can see how easily this can be missed.

The symptoms women are more likely to experience during a heart attack at least half the time are:

• Shortness of breath
• Weakness or unusual fatigue
• Dizziness, cold sweats, nausea or vomiting.

Even more interesting to me is that women frequently experience early warning signs of an impending heart attack up to a month before the event and these symptoms can include:

• Unusual fatigue
• Sleep disturbances
• Shortness of breath
• Indigestion and anxiety or
• An impending sense of doom.

These symptoms are obviously not unique to only heart disease. In fact, they can represent a wide range of health related problems from blood disorders to intestinal concerns to mental health issues.

However, the take home message is, if you're experiencing symptoms, any symptoms that are abnormal for YOU, don't write it off as something silly or insignificant like, "just stress." Pay attention to it and ask your doctor what it means. Remember that women's symptoms are not as predictable as men's, so if you feel your concerns are not being taken seriously, be persistent until you have an answer you feel comfortable with. Only you can know if something's not right and then it's up to your healthcare providers to figure out the answer.

I think we can all agree it's much easier to say, "Gee, I'm glad it's nothing serious," than to look back and wish you hadn't dismissed it.

Q: What should a woman do if she believes she's experiencing a heart attack?
First and foremost, call 911 and don't hesitate. People are often shy about doing so yet the 911 operators are trained for this. Why don't we want to bother the people who are trying to save our lives? Oh come on!!! Delay is the number one reason for poor outcomes.

Second, if you are alone, try to find someone to be with you until the Medics arrive. If for some reason the Medics don't arrive, you want to be driven to the nearest emergency room, and please, do not drive yourself.

Lastly, chew a whole aspirin. Taken at the time of a heart attack, this simple trick can significantly reduce mortality.

If your listeners would like further information about women and heart disease, I suggest they check out the American Heart Association's website, or email me care of this radio show at info@chatwithwomen.com.

To your good health!
Dr. Larry