By: Jean Johnson for Heart1
Of all the women who die each year from heart attacks, 2/3 had no symptoms that either the physician or the patient identified as serious. And according to the National Coalition for Women with Heart Disease, the only patient-advocacy group organization founded by and for women with heart disease, heart disease takes the lives of more than 250,000 American women each year, making it the leading cause of death at six times the rate of breast cancer.
It’s not news that advances in the care of women with heart disease have lagged significantly behind those associated with men. Throughout the 20th century cardiac problems have traditionally been considered most prevalent in males. Thus, when women experience symptoms, they tend to be dismissed and opportunities for critical early intervention are missed.
“I had radiation damage to my left descending artery after treatment for non-Hodgkin’s lymphoma. The radiation scarred the artery, leading to angina pain when I was at rest – the most dangerous type of angina,” said Washington state resident Sylvia Hartman. Since her symptoms weren’t “a normal clinical presentation of heart disease, I had trouble getting my doctor to listen to me instead of passing me off as a hysterical woman who needed a psychiatrist.”
Rather than the “Hollywood Heart Attack” in which chest pain causes a person to collapse on the floor, women more often experience nausea, indigestion or fatigue before and during a heart attack. In a study of 515 women, only 1/3 had chest pain although they described it as more of an aching or tightness. Also, 71 percent of the women complained of unusual fatigue with half of them noting sleep disturbance. The range of symptoms started as much as a month prior to the actual cardiac event, and in women that experienced a second attack, their symptoms were sometimes different than the ones they initially had.
Physicians have the greatest success in treating patients within the first two hours after heart attacks. Measures including drugs to control blood clots and balloon angioplasty lose their effectiveness after this window of time, and instances of death and lasting heart damage rise.
| What to Watch For |
Tips for Women
1. Aching or tightness in the chest
2. Unusual fatigue with or without sleep disturbance
3. Anything unusual with your body – Listen to your body’s signals
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Yet, according to a 2003 Mayo Clinic analysis of the “first-ever national survey of women heart patients,” 58 percent said physicians either did not take their complaints seriously or simply told them to lose some weight and get more exercise. In particular women singled out physicians for their “insensitivity, rudeness, abruptness, and ignorance about heart disease in females.” The women also noted they often did not have the funds or insurance coverage for nutrition counseling and weight management services, and that they tended to experience anxiety and depression in addition to their heart-related symptoms.
Advocates in the field of women’s heart disease say that a key to changing this pattern is by women listening to their own bodies, taking their symptoms seriously, and insisting that their physicians do the same. It puts an additional burden on women who are already suffering from an array of symptoms. Still, given the current state of confusion in caring for women with heart disease, listening is an essential tool.
