Women, Beware:

That Sweaty Feeling and Stomach Ache Could Be a Heart Attack

  Jean Lawrence, Medical Writer:

Nancy Loving was only 48 when she noticed a pain in the center of her back. She twisted and stretched, but it persisted. "Something told me to go to the hospital," she says. Sure enough, she was having a heart attack. Although there are many stories of women with such vague symptoms being sent home with a roll of antacids, she was treated and is fully recovered.

"It was a shocker," she recalls. Like many women, she had always been more worried about breast cancer. Yet, bar none, heart disease is the biggest killer of women, just as it is of men! This year, 240,000 women will die from heart disease. In the 45-64 age group, heart disease kills twice as many women as breast cancer.

Part of the reason for the high mortality is that women--and, yes, some physicians--fail to recognize the symptoms of a heart attack in women and institute effective treatment soon enough.

We've all heard doctors talk about the common symptoms in men: that crushing chest pain that feels like a truck--or elephant--sitting on the chest. They describe the classic symptoms of a heart attack as a heavy pressure or squeezing in the center of the chest, sometimes associated with pain radiating into the left arm or jaw, nausea or vomiting, shortness of breath, light-headedness, palpitations, or sweating.

Women may have the classic symptoms of heart attacks just as many men do. However, many women do not have the classic symptoms and may instead complain of less common symptoms. Women may have a sharp pain rather then a pressure sensation, and sometimes lack any discomfort in their chest altogether. Extreme tiredness can be another symptom in women that can sometimes be mistaken as part of another illness. One woman talked about "a sudden pressure drop inside her." Dizziness or unexplained blackouts can predate the attack. Perhaps just breathlessness, that feeling of waking in the night and being unable to catch a breath. Women also may notice some swelling in their legs or ankles, fluttering heartbeats, or nausea. Sweatiness or clamminess during the attack itself is also common.

This year, 240,000 women will die from heart disease.

Fatigue, sweatiness, a nervous tightening in the chest? That could be anything! "Women need a reality check," Loving says. "Heart disease kills nearly half of all women, yet women are so busy taking care of everyone else in the world, they ignore their own problems."

To increase awareness, Loving and two other heart attack survivors formed WomenHeart (http://www.womenheart.org). "Heart disease in women," she says, "is where breast cancer was 20 years ago--hidden, carrying a stigma. Because women usually get their attacks 15 years later than men, saying they've had a heart attack makes some women sound old. The don't want to admit it or talk about it."

Can't Doctors Increase Awareness? In some cases, physicians may be part of the problem. According to many reports, women go to doctors more than men. It is possible that almost like "the boy who cried 'wolf,'" their complaints may be taken less seriously than men's. Indigestion or a "panic attack" is a common diagnosis. "The medical establishment is woefully ignorant," snaps Phyllis E. Greenberger, MSW, executive director of the Society for Women's Health Research in Washington, DC, a group bent on improving the situation. "Some doctors even believe that women don't get heart disease," Loving adds.

Secondly, most of the research that has been done on heart disease has been conducted on men. "Women are not little men!" Loving exclaims.

"There is a lot of interesting speculation on why women aren't being studied much," agrees Greenberger. "This is an entrenched mentality on the part of both women and the scientific establishment. The pattern has been that men are usually studied.

When women are included in a study, though, it is important that the genders be differentiated. Women and men's bodies do behave differently. For one thing, it's fairly well accepted that estrogen in women can have some protective effect against heart disease. Women can also react differently during stress tests. There is evidence that those tests aren't as good for detecting heart disease in certain women. Yet, we often see studies now that talk about "patients," mixing the men and women. "There has to be gender analysis!"

Most of the research that has been done on heart disease has been conducted on men.

Greenberger also thinks outreach is necessary to get women to participate in studies involving heart disease. "Women need to enter these clinical trials," she says. "Why don't they? We are trying to determine that."

What Can Women Do for Themselves? "First," Loving says, "women need to realize they may be at risk." Greenberger points out that even if heart attacks have occurred on the male side of your family, that counts as genetic risk.

Expressing her personal opinion (and apparently not that of the medical community), Loving recommends that every postmenopausal woman consult a cardiologist as a kind of initial visit. "We never want to go to the doctor until we are half dead," she sighs. "Well, this is not the time to wait." Greenberger recommends that women at least get a baseline electrocardiogram (ECG) around that time. Sometimes you have to ask for it, but most health plans will cover the cost.

If you do experience unusual sensations, meaning back pain, arm pain, clamminess, or exhaustion, she and Loving recommend that you be assertive with your doctor or emergency room personnel. "If you start noticing a constellation of symptoms that don't go away," Greenberger says, "better safe than sorry."

When you get to the doctor, tell him or her that you feel poorly, be exact, explain that this is unusual for you, say that something is wrong.

"Think of what you would tell your husband if he sat across the breakfast table complaining of all these symptoms," Greenberger advises. "Would you tell him to call the doctor or go to the hospital? I guess what I am saying is use your woman's intuition. It could save your life."

Heart Attack Symptoms in Women:
Shortness of breath
Difficulty breathing
Pain or weakness in the shoulder, arms, or all over the body
Nausea not relieved by burping or antacids
Overwhelming fatigue
Chest pain

Source is Jean Lawrence, Medical Writer.

For more information on Heart Attacks (myocardial infarctions) MIs, please see Heart-Help's Heart Attack Page

Url is www.heart-help.net
Last Modified on November 8, 2001