Although it's commonly thought of as a man's disease, heart disease is the No. 1 killer of women and more deadly than all forms of cancer combined, according to the American Heart Association. In fact, one woman is killed by heart disease every 60 seconds.
To make matters worse, an increasing number of women die of undiagnosed heart attacks, partly because they don’t perceive their symptoms to be classic signs of a heart attack. For example, while most of us think that the telltale sign is extreme chest pain, a 2013 study published in JAMA found that one in five women age 55 and younger didn’t experience chest pain during a heart attack.
Because symptoms can vary greatly between men and women, they’re often misunderstood. A woman who's having a heart attack, for instance, may under-report her symptoms, saying: It's probably heartburn; I'm just feeling some pressure; I think I'm having hot flashes; I'm just a little dizzy. And emergency responders may not immediately discern the real cause of her problem.
Dr. Bairey-Merz's Key Findings on Female Heart Disease:
• Women who have a history of irregular menstrual cycles, estrogen deficiencies and polycystic ovary syndrome may have a higher risk of developing heart disease as they age.
• Women can have normal angiograms even when they have ischemic heart disease.
• Women are often told their stress tests are normal or that they have "false positives." Bairey Merz says doctors should pay attention to symptoms such as chest pain and shortness of breath rather than relying on a stress test score.
• Women who exhibit symptoms of ischemic heart disease can benefit from treatments ranging from proper medication to reduce heart attacks and control symptoms, as well as lifestyle changes, such as losing weight, eating a low-fat diet and exercising regularly.
In The Patient’s Playbook, Dr. C. Noel Bairey-Merz, director of the Barbra Streisand Women’s Heart Center at Cedars-Sinai Medical Center in Los Angeles, reveals the four words she tells her patients to say in order to get medical responders' attention.
"You have to say: 'I have chest pain,'" Dr. Bairey-Merz says. If you have a heart condition, or if there's a history of heart disease in your family, these four words can become a life-saver. "You must say: 'I'm having chest pain,'" Dr. Bairey-Merz advises. "And if they don’t give you an EKG and do a blood test, demand it."
The good news is that we have more ways than ever before to manage risk factors such as high blood pressure, high cholesterol, and high blood glucose. So discuss your family history with your physicians, ask about screening measures, and take steps to reduce your risk. That might mean following a heart-healthy diet and exercising regularly, quitting smoking, decreasing sodium intake—all goals that your doctor can help you achieve. And if you find that diet and exercise alone aren't enough, your physician can recommend medications—such as statins or blood pressure drugs—that might be right for you.
Emergency responders have also helped the death rate from coronary heart disease to fall about 38%, thanks in part to decreased "door-to balloon times"—which means the time from when a heart attack patient arrives in the emergency department until percutaneous coronary intervention (PCI) is performed to open blocked arteries. (The sooner, the better, but the American Heart Association and American College of Cardiology recommends PCI within 90 minutes.)
Finally, every woman, no matter her health history, should be aware of the symptoms of a heart attack, which, according to the American Heart Association, can include:
- Uncomfortable pressure, squeezing, fullness or pain in the center of your chest that lasts more than a few minutes, or goes away and comes back.
- Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without chest discomfort.
- Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
See Go Red for Women, for more ways to prevent, manage, and treat heart disease, as well as helpful tips on recognizing the symptoms of heart attack and stroke.