Imagine a scene in which someone is having a heart attack.
Now there is a better than average chance that in your mind you just pictured a middle-aged man in severe pain, grabbing his chest, gasping for air and collapsing to the ground. Too many of us think that heart disease and heart attacks are predominately concerns for men. Facts, however, reveal that women should be just as concerned, if not more so.
- In every year since 1984, more women have had heart attacks than men.
- Heart disease is the number one killer of women in the United States.
- Heart disease kills more women each year than all forms of cancer combined.
- 9 out of 10 women have at least one risk factor for heart disease.
- Certain complications of pregnancy increase the risk of heart disease.
- Diseases that disproportionately affect women (breast cancer, lupus, rheumatoid arthritis) may increase the risk of heart disease.
- The risk of heart disease triples after menopause.
Know the Terms
Before going any further, let’s become familiar with some of the terms most often used (and confused) when discussing heart attacks.
Cardiovascular disease (CVD)
Cardiovascular disease (CVD) is an umbrella term covering all types of diseases that affect the heart or blood vessels.
Heart disease is a type of CVD covering several conditions that affect the heart. Many forms of heart disease can be prevented by choosing healthy behaviors and lifestyles.
Coronary artery disease (CAD)
Coronary artery disease (CAD) is the most common form of heart disease. It is sometimes called coronary heart disease. CAD occurs when a build-up of plaque forms in the arteries. The plaque narrows the inside of the artery, reducing the amount of blood flowing throw it. The plaque can also rupture, and pieces of it can break off to form a blood clot. CAD can lead to a heart attack or a stroke.
Heart attack occurs when blood flow to the heart muscle is blocked. When the muscle lacks blood, it begins to die and can result in permanent damage to the heart’s ability to pump blood. There are several conditions that can cause a heart attack, but CAD is the most common cause. A heart attack is sometimes called a myocardial infarction.
Cardiac arrest occurs when the heart’s electrical system stops working properly. Cardiac arrest causes the heart to beat chaotically or stop beating altogether. During a heart attack, the heart continues to beat. However, a heart attack can lead to cardiac arrest.
Stroke occurs when a blood vessel that supplies the brain bursts or becomes blocked. If a myocardial infarction is a called a heart attack, a stroke could be called a “brain attack.”
What are the Symptoms of a Heart Attack in women?
Chest discomfort is the most common symptom of heart attack in both women and men. The pain or tightness in the chest is usually centrally located in the chest (or slightly to the left side), made worse by stress or physical activity and gets better when at rest. The intensity of the discomfort can range from mild to “feeling like an elephant is sitting on my chest.”
Women are much more likely to have a heart attack without experiencing chest discomfort than men. It is important to know that heart attacks can occur without any chest discomfort at all.
In a 2003 study of women who had experienced a heart attack, the most common symptom was not chest-discomfort. Rather, they reported fatigue, changes in their sleep and anxiety. Nearly 80% of the women in that study reported that they experienced one or more symptom at least one month before their heart attack.
In addition to chest discomfort, women can commonly experience one or more of the following heart attack symptoms:
- Unusual fatigue lasting for several days or sudden severe fatigue
- Inability to sleep
- Anxiety or feelings of impending doom
- Lightheadedness/ dizziness
- Shortness of breath (with or without chest discomfort)
- Rapid or irregular heartbeat
- Indigestion/ heartburn
- Nausea/ vomiting
- Pain in the upper back, shoulders, arms, abdomen, throat, jaw or teeth
- Cold sweats / clammy skin
Don’t Ignore Your Symptoms
A common misunderstanding of heart attacks is that the symptoms are unmistakable. This leads many to think that, “If I have a heart attack, I will know it for certain.” This is simply not true. Unfortunately, the consequence of this error in thinking can be a matter of life and death.
Symptoms of heart attacks vary from person to person, and they may be difficult to recognize. Even a person who has had more than one heart attack may experience different symptoms with each attack. Symptoms may mimic other, less life-threatening conditions, causing a heart attack victim to ignore them. Therefore, it is important to know which heart attack risk factors you have, listen to your body and pay attention to all symptoms you are experiencing. If you think you might be having a heart attack, get help immediately. According to the Mayo Clinic, “Women tend to show up in emergency rooms after heart damage has already occurred because their symptoms are not those usually associated with a heart attack, and because women may downplay their symptoms.”
The inconvenience or perceived embarrassment of a heart attack “false alarm” is greatly outweighed by the benefits of responding to the early warning signs and avoiding the serious health consequences of a full-blown heart attack. If you think you are experiencing the symptoms of a heart attack, call 9-1-1 immediately. Do not attempt to drive yourself anywhere. Initially, you may feel fine enough to drive yourself; but the symptoms of a heart attack can intensify to the point that is dangerous for you to be behind the wheel.
Am I at Risk for Heart Disease?
As you grow older, your risk increases for heart disease and heart attack. This is true for everyone. Regardless of age, there are other risk factors that are important to know and understand. Some of these are controllable and some are not. Some are related to other diseases, some are related to genetics and others are related to chosen behaviors and lifestyles. The risk factors for heart attacks include:
- Poor diet
- Lack of physical activity
- Excessive alcohol use
- High-stress level
- High blood pressure
- High LDL cholesterol
- Certain drugs and cancer treatments
- Family history of heart disease
- Abnormal heartbeat
Many of the risk factors listed above are actually more dangerous for women than for men. For example, women who smoke and use any form of combination hormonal birth control have a higher risk of blood clots forming and increased blood pressure. Both blood clots and high blood pressure can lead to a heart attack.
Another example of a risk factor that affects women more than men is diabetes. Women with diabetes are more likely to have additional risk factors such as obesity, high blood pressure and high cholesterol. For women who have had one heart attack, diabetes doubles their risk for a second attack.
There are also risk factors that are unique to women.
Menopause results in the decrease of estrogen levels in a woman’s body that may affect the lining of her blood vessels and may cause an unhealthy balance between her good and bad cholesterol. These post-menopausal changes can allow plaque to form in the blood vessels and significantly increase a woman’s risk of heart attack.
Complications with pregnancy
Complications with pregnancy such as gestational hypertension or gestational diabetes increase a woman’s long-term risk of developing high blood pressure and diabetes after the pregnancy. Both of these conditions increase a woman’s risk of heart attack.
Auto-immune disease may also affect a woman’s risk factors differently than men. Research is showing that women with lupus or rheumatoid arthritis have an increased risk of heart attack.
What Can I Do to Prevent a Heart Attack?
You have control over some of your heart attack risk factors. Even if you have heart disease and have already had a heart attack, there are things you can do to prevent another attack.
Seeing your doctor regularly.
Regular visits to your doctor are critically important to the prevention of heart attacks and for your overall health. Good communication between you and your doctor allows you to know which heart attack risk factors you have and how best to manage them. Knowing your risk factors gives you more control and helps you to make informed decisions that lead to a healthier lifestyle. Your doctor can recommend behaviors and medications to help reduce your specific risk factors, and regular visits allow your doctor to properly track them.
If you smoke, quitting will have a greater effect on your risk for heart attack than any other change in behavior you can make. People who quit smoking for one year will reduce their risk of heart attack by 50%. Statistically, women smokers have a more difficult time quitting than men. Smoke Free Women is the name of a website containing great information and resources for women who want to quit. Your doctor can also help.
The heart, like any other muscle, needs regular exercise. 30 minutes of physical activity (even walking) at least 5 times per week can help keep your heart muscle healthy, and can keep your blood vessels flexible and strong. Physical activity can also reduce risk factors related to high blood pressure, obesity and diabetes.
Eating the right foods and the right portions of those foods is an important part of heart health. Like exercise, eating a healthy diet helps reduce a number of heart attack risk factors. It can even help provide the energy for your increased physical activity. There is not a specific food, vitamin or supplement that is going to help you prevent a heart attack. Instead, eating healthy is about eating a combination of foods from different food groups. There are a number of online tools to help you plan your diet and choose the right foods.
Limit alcohol use.
If you don’t drink, don’t start. If you drink, it should be done in cautious moderation. You may have heard claims that one glass of beer or wine can have certain health benefits; but there is no evidence that any amount of alcohol is good for your heart. It is well-known, however, that excessive alcohol use can raise your blood pressure and damage your heart. If you are pregnant or taking certain medications, you should not be drinking any amount of alcohol at all.
Take your medication as prescribed.
If you are taking a prescribed medication for heart disease or a condition that is considered to be a risk factor for heart disease, follow your doctor’s directions exactly as printed on the bottle or box. If you believe the medication is causing side effects that you cannot live with, don’t stop taking the medication until after consulting with your doctor.
Life after a Heart Attack
If you are one of the thousands of women who has had a heart attack, you are probably still dealing with the aftermath of that life-altering event. Know this: you don’t need to do it alone. Many organizations and online communities exist for the sole purpose of supporting women who are struggling with life after a heart attack. They offer information, services, encouragement and hope.
Centric Healthcare also offers services that can help you. Here are two:
Whether you are a heart attack survivor or you are living with major risk factors and trying to prevent a heart attack; there is a good chance that medication therapy is a part of your daily life. Centric Healthcare offers Medication Therapy Management (MTM) services that are coordinated with your pharmacist to help optimize the therapeutic outcome of each medication prescribed to you. MTM services help you or your caregiver to understand each medication you are taking, to know how and when to take your medication properly, to understand the possible side effects of the medication and to help you understand possible interactions with other medications you are taking.
Following a heart attack, the critical lifestyle changes, the fear and the emotional trauma of the entire ordeal can be overwhelming. Adjusting to life after a heart attack can be made easier with the services of a medical social worker. Medical social workers are experienced and skilled at coordinating all the different aspects of your recovery plan. They know where the resources are and how to access them. They can help reduce the stress and anxiety of trying to make sense of all the moving parts of your plan so that you can focus on getting better and living healthier.