February is heart health month, and because we love you and want you to be well, we’re going to ask you to sit down and read this. Really read this. Follow the links below to our sources for more information about heart attacks in women. Then take steps today – yes, today – to protect your heart and your future.*

For too long, we’ve thought of heart disease as predominantly a man’s problem, but the truth is that heart disease is the number one cause of death in women. We especially want you to pay attention if you’re post-menopausal, because about 10 years after menopause, a woman’s risk of suffering a heart attack increases significantly, pulling equal with men’s. Why?

Heart disease risk factors and menopause

Well, estrogen may have a protective effect, helping to keep artery walls flexible, just as it does with vaginal tissue. Other contributing post-menopausal changes include increases in blood pressure, LDL (“bad”) cholesterol, and triglycerides (fats in the blood), while good cholesterol (HDL) levels decrease or stay the same.

During menopause, many women experience interrupted sleep, and increased depression and anxiety, all of which can add extra stress on the heart. Some women gain weight during this time as shifts in hormones affect metabolism and energy levels. The extra weight tends to concentrate around the middle, making it an added risk factor.

All of this adds up to: menopause is your body’s way of telling you to take good care of yourself. In next week’s blog we’ll go into the specifics of how you can do that.

For now, we think it’s incredibly, ridiculously, desperately important that everyone understands the signs of heart attack in women. The signs can be vastly different than men’s, and even medical professionals can miss the signals. Know what to look out for so you can protect yourself and others.

What a heart attack can look like in women

We’re so familiar with the classic male signs, most of us can spot a Hollywood heart attack before the actor even grabs his chest: tingling in the left arm, terrible chest pain, shortness of breath, nausea, pain in the jaw, neck, back, or stomach.

Women’s symptoms can differ in type and severity, and in some cases, women may have no symptoms at all. Here are the signs to look out for, according to WomensHealth.gov:

  • Chest pain or discomfort.
    • Often described as “pressure,” “squeezing,” or “fullness.”
    • According to Harvard Health, only one woman in eight reports chest pain during a heart attack, and then they may experience “pressure, aching or tightness” – not pain. This is not the only sign to think about, and for women, it may not be the best one.
  • Unusual upper-body discomfort.
    • May present in the neck or jaw.
    • This is more common among women than men.
  • Shortness of breath.
  • Breaking out in a cold sweat.
  • Unusual or unexplained fatigue.
  • Light-headedness or sudden dizziness.
  • Nausea
    • Women are twice as likely as men to have nausea and vomiting during a heart attack.

Unfortunately, many of these signs are also present during perimenopause or menopause, which makes them more likely to be dismissed by women and by medical health professionals. But you know your body best – if the symptoms are accompanied by chest pain or tightness, or are different, more intense, last longer, return more often, or happen concurrently, get medical help right away.

Not only are some of women’s heart attack symptoms dangerously similar to menopause, they simply may be more subtle in women, causing women and their doctors to dismiss their illness as flu, acid reflux, panic attack, or fatigue.

Women often don’t get help soon enough

It’s crazy that we even have to say “It’s OK to get help,” but according to a 2012 survey by the American Heart Association, only 65% of women would call 9-1-1 first if they thought they were having a heart attack. Umm…..what?! And if a woman makes it to a hospital, she still runs a higher risk of delayed or incorrect treatment.

There are a few reasons women don’t seek or get the help they need as quickly as they need it.

First, many of us – men and women – still cling to the myth that heart attacks happen to men or are signaled by crushing chest pain. And so we may not respond appropriately when a woman complains of fatigue or dizziness, especially when she doesn’t have the chest pain we expect.

Second, culturally, many women don’t feel comfortable being the center of attention or causing a bother to others. If the symptoms are moderate enough to endure, women may simply endure them for a dangerously long time.

Third, because women’s symptoms are different or seem milder, they are more often misdiagnosed, resulting in treatment delays.

Finally, because we’re only now beginning to understand the impact of heart disease on women, many diagnostics and treatments are inappropriate for women – dosages may be too high, surgeries are more difficult given women’s smaller arteries, and women’s responses to standard stress tests differ from men’s, complicating diagnosis.

What to do if you suspect you’re having a heart attack

If you or someone with you is experiencing symptoms, call 9-1-1. Not only will you likely get to a hospital sooner, you’ll get medical help along the way, and you’ll likely get quicker treatment when you arrive. Chew and swallow an aspirin, as long as you’re not allergic. A highly effective blood thinner, aspirin can help improve your chances of survival.

When talking with medical professionals, be your own best advocate. If you believe you’re having a heart attack, tell the doctor. Don’t underplay the severity of your symptoms. You have the right to have your concerns taken seriously, so make sure you’re heard. If you have risk factors for heart disease or have had a prior attack, appoint someone who can speak for you. Be sure their contact information is easily found in your wallet or on your cell phone.

Knowing the symptoms of heart attack can save your life

A woman has a heart attack every 90 seconds in the US. Knowing the symptoms and having a plan in place can save your life, or someone else’s.

Next week we’ll talk about exercise, nutrition, and lifestyle choices that may help you reduce your risk of heart disease. But don’t wait for us. Go eat something green, throw away your cigarettes, go for a walk in the woods, and hug someone you love.

And have a very, very Happy Heart Health Month.

Read part 2 of this series here.

*This blog is not intended to replace expert advice by a doctor. If you’re having concerns, please seek medical attention immediately.

Quoted and consulted sources:

http://www.health.harvard.edu/heart-health/gender-matters-heart-disease-risk-in-women
http://www.heart.org/HEARTORG/Conditions/911-Warnings-Signs-of-a-Heart-Attack_UCM_305346_SubHomePage.jsp
http://www.theheartfoundation.org/information-on-women-and-heart-disease/
https://www.womenshealth.gov/heartattack/
http://www.cedars-sinai.edu/About-Us/HH-Landing-Pages/When-it-comes-to-heart-disease-women-and-men-are-not-equal.aspx
https://www.heart.org/idc/groups/heart-public/@wcm/@adv/documents/downloadable/ucm_483545.pdf
https://www.cardiosmart.org/News-and-Events/2015/03/Delays-in-Treatment-Worsen-Heart-Attack-Outcomes-in-Women


Shannon Perry

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