According to the CDC, heart disease is the leading cause of death in the U.S. But shockingly, the World Health Organization says that 80 percent of heart disease is preventable. That’s right, 80 percent. The most common risk factors for heart disease are smoking, high cholesterol, high blood pressure, inactivity, obesity and diabetes. You can prevent heart disease by doing things like exercising, eating right and quitting smoking, but that’s for another article.
First, let’s talk a little science so you know why heart attacks happen. A heart attack happens when the blood flow that brings oxygen to the heart is severely reduced or stopped. This occurs because over time, the arteries that supply the heart with blood can slowly become thicker and harder from a buildup of fat, cholesterol and other substances. This process is known as atherosclerosis. If the plaque breaks open and a blood clot forms, it can block the blood flow in the vessel, causing a heart attack. Heart attacks are perhaps the most feared complication of heart disease, so it’s important to learn how to spot the signs. We’ve all seen the classic signs of a heart attack in movies. It can be dramatic and sudden, and can include:
- Chest pain in the center of your chest that can feel like squeezing, pressure or fullness and can radiate down the left arm or to other areas. The pain can come and go and lasts longer than a few minutes. It has often been described as “having an elephant sit on your chest” or “having your chest in a vise.”
- Shortness of breath
- Palpitations or heart racing
The American Heart Association and a body of recent research suggest that this typical picture of a heart attack is more typical for men who experience symptoms. A report by BlueCross BlueShield revealed that while heart attacks are more common in men, women “who experience heart attacks have worse outcomes — they are more likely than men to die within one year of a heart attack, to have another heart attack within six years, and to be disabled because of heart failure within six years.” Women receive less aggressive treatment after a heart attack than men and often delay care longer than men. This is why it is especially important that women learn to identify signs of a heart attack. For women, the picture can be more insidious than the dramatic Hollywood heart attack. While chest pain is still a common symptom for women, many have atypical symptoms that can seem more like the flu than a heart attack. Some don’t even have chest pain. For women, signs of a heart attack can include more than the typical symptoms above, such as:
- Unusual fatigue
- Trouble sleeping
- Pain in neck, jaw or back
- Stomach pain
There’s a story circulating in national news about a local woman who believed she was suffering symptoms of a viral illness. She wanted to sleep it off, but at the insistence of her husband, she went to the emergency room and discovered she was in the throes of a heart attack. These stories are common, so it’s important to listen to your body. If you don’t feel right, go in to the hospital and get checked out. If you do believe that you are suffering the symptoms of a heart attack call 911 immediately and, according to a suggestion by Harvard Medical School, chew a tablet of aspirin.
By 2020, the American Heart Association wants to improve the cardiovascular health of Americans by 20 percent and reduce death from cardiovascular disease by 20 percent. The key to this goal is education. Let’s all work together to spread awareness of the preventable nature of heart disease and the subtle signs of a heart attack.
February is American Heart Month. Learn about heart disease in women and what you can do to keep a healthy heart.
Get Informed: Facts on Women and Heart Disease
- Heart disease is the leading cause of death for women in the United States.
- Although heart disease is sometimes thought of as a “man’s disease,” around the same number of women and men die each year of heart disease in the United States.
- Some conditions and lifestyle choices increase a person’s chance for heart disease, including diabetes, overweight and obesity, poor diet, physical inactivity, and excessive alcohol use.
- High blood pressure, high LDL (low-density lipoprotein) cholesterol, and smoking are key risk factors for heart disease. LDL is considered the “bad” cholesterol because having high levels can lead to buildup in your arteries and result in heart disease and stroke. Lowering your blood pressure and cholesterol and not smoking will reduce your chances for heart disease.
While some women have no symptoms of heart disease, others may experience heavy sharp chest pain or discomfort, pain in the neck/jaw/throat, or pain in the upper abdomen or back. Sometimes heart disease may be silent and not diagnosed until a woman has signs or symptoms including:
- Heart Attack: Chest pain or discomfort, upper back pain, indigestion, heartburn, nausea/vomiting, extreme fatigue, upper body discomfort, and shortness of breath.
- Arrhythmia: Fluttering feelings in the chest.
- Heart Failure: Shortness of breath, fatigue, swelling of the feet/ankles/legs/abdomen.
- Stroke: Sudden weakness, paralysis (inability to move) or numbness of the face/arms/legs, especially on one side of the body. Other symptoms may include confusion, trouble speaking or understanding speech, difficulty seeing in one or both eyes, shortness of breath, dizziness, loss of balance or coordination, loss of consciousness, or sudden and severe headache.
Heart disease is largely preventable.
Listen to CDC’s Dr. Bowman discuss ways to prevent heart problems.
What You Can Do for Heart Health
You can lower your chance of heart disease and a heart attack by taking simple steps.
- Eat a healthy diet with fruits, vegetables, whole grains, and fat-free or low-fat milk and milk products. Choose foods low in saturated fats, cholesterol, salt (sodium), and added sugars.
- Exercise regularly. Adults needs 2 hours and 30 minutes (or 150 minutes total) of exercise each week. You can spread your activity out during the week, and can break it up into smaller chunks of time during the day.
- Be smokefree. If you are ready to quit, call 1-800-QUIT-NOW (1-800-784-8669) or 1-855-DÉJELO-YA (1-855-335-3569 for Spanish speakers) for free resources, including free quit coaching, a free quit plan, free educational materials, and referrals to other resources where you live.
- Limit alcohol use, which can lead to long-term health problems, including heart disease and cancer. If you do choose to drink, do so in moderation, which is no more than one drink a day for women. Do not drink at all if you are pregnant.
- Know your family history. There may be factors that could increase your risk for heart disease and stroke.
- Manage any medical condition you might have. Learn the ABCS of heart health. Keep them in mind every day and especially when you talk to your health provider:
- Appropriate aspirin therapy for those who need it
- Blood pressure control
- Cholesterol management
- Smoking cessation
DEAR DR. ROACH: My question is about symptoms for women’s heart attacks. I have always heard that symptoms for women can be much different from men’s. Instead of the chest-clutching, sharp pain that men can have, I have read that women’s symptoms can be any of these: heartburn or indigestion; pain in the jaw, neck, shoulders, back, one or both arms; fatigue and troubled sleep; dizziness and nausea; or extreme anxiety. Are you KIDDING me? I am a healthy, active 63-year-old woman. I have had all of these symptoms at one time or another. If I acted every time I had one of these symptoms, I would be at the doctor’s office every day. How is one to know which symptoms to take seriously and act on immediately, and which to wait a few days to see if it is temporary?
Thank you for addressing this confusing issue. — J.
ANSWER: I have seen many letters similar to yours. The confusing problem is that it’s true: In women, heart attack symptoms and the symptoms of angina before a heart attack can include all of those vague symptoms. The same is true of men as well, although it’s more likely for women than for men to have symptoms other than the classic left-sided chest discomfort (people are much more likely to describe angina as “discomfort” or “pressure” than “pain”).
So your question is entirely valid: How do you know when to take common symptoms seriously? The first thing I would say is that the greater your risk for heart disease, the more seriously you should take any symptom. Age, family history of heart disease, high blood pressure and cholesterol, lack of regular physical exercise and diabetes are among the most important risk factors.
The second thing I would say is to take new symptoms seriously. If you never get heartburn, for example, then heartburn at age 63 should prompt concern.
Third, context matters. Symptoms such as nausea or jaw pain that occur with exercise — even carrying a bag of groceries or walking up stairs — is definitely a reason to talk to your doctor.
Most women don’t know that heart disease remains their No. 1 killer, far outstripping breast cancer (or any cancer). Both women and men need to take even vague symptoms seriously, especially if the symptoms are new, exertional or if the person has several risk factors. As a primary-care doctor, I’d rather see my patient for her concerns that symptoms may be heart disease than see her in the ICU with a heart attack.
A heart attack occurs about every 20 seconds with a heart attack death about every minute…
- 1.5 million heart attacks occur in the United States each year with 500,000 deaths.
- More than 233,000 women die annually from cardiovascular disease.
- A heart attack occurs about every 20 seconds with a heart attack death about every minute.
- Sudden death is more common among women with heart attack.
- The National Registry of Myocardial Infarctions (New England Journal Med., 22Jul99) reports that women have a worse outcome than men after having a heart attack. Data showed that women under the age of 50 had twice the mortality of men after having a heart attack. Variances likely reflect increased severity of the disease in younger women.
- Almost 14 million Americans have a history of heart attack or angina.
- About 50% of deaths occur within one hour of the heart attack ––outside a hospital.
- There is a 6% to 9% early mortality from heart attack for those who survive long enough to…
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Studies show that 48 percent of people can develop depression following a heart attack. But experts say this depression may not be purely psychological. After a cardiac event, the heart may be unable to pump blood as efficiently—causing patients to lose energy.
In addition, chemicals are released in the brain that can work to physiologically cause mood changes. Interestingly, the same study showed that women who suffer heart attacks are 20 percent more likely to develop depression.
The good news: most of these cases can be treated with anti-depressant drugs.