By Jamie O’Toole
Picture the moment: a man grasps his chest, struggling for breath and unable to stand while people begin to frantically call for a doctor before it is too late. It is assumed heart attacks are impossible not to miss, but in reality, heart attacks in women often go unnoticed posing a fatal risk.
“Everyone thinks of heart attack symptoms as an elephant sitting on your chest. Women do experience that sometimes, but often women’s symptoms are more subtle,” explains Dr. Deborah Shirey, Assistant Professor of Nursing at Texas A&M University’s Health Science Center in Round Rock. “People may be inclined to think that all heart attacks present with pronounced symptoms, but sometimes they can be quite subtle.”
According to recent studies by the National Institute of Health and the American Heart Association, women often display a different set of symptoms than men when experiencing a heart attack. Assistant Professor of Nursing at Texas A&M Mary Alice Middlebrooks says, “When women have a heart attack, it’s not so much the elephant on chest feeling and the pain down the left arm, but rather pain to the throat or upper back, so the pain is in a different location.” While women can exhibit the same symptoms, less severe but longer lasting pain are more common. “They often described it more like the pressure of a rope tied around their chest and not a sharp pain, and sometimes it lasted as long as 30 minutes,” adds Middlebrooks.
“Women tend to have a lot more symptoms the month before they actually have their heart attack: shortness of breath, being really tired or fatigued, sleep disturbances, nausea, some think they have the flu even,” says Middlebrooks. In contrast, men generally report feeling normal and experiencing nothing out of the ordinary in the weeks leading up to a heart attack.
If women experience symptoms that indicate an approaching heart attack, why are heart problems not discovered sooner?
“Women just need to be more educated. Plus, women don’t think they have time to go and seek healthcare even if they think something might be wrong, so they often won’t go get checked out for it,” says Dr. Shirey. Because signs of a woman’s heart attack are largely non-traditional, symptoms tend to be overlooked or attributed to something else. Women will also ignore or disregard symptoms due to inconvenience. “Women will discredit tiredness with ‘Oh, I am just busy this month’ or other excuses, but they need to get checked out,” says Middlebrooks. “We are encouraging ER nurses to be better informed as well, but women need to insist on an EKG if they have had persisting symptoms.”
While heart health has traditionally been more focused on men, raising awareness among women is crucial. One in every three women dies from heart disease. “Women need to know what all the risk factors are, regardless of their age,” advises Middlebrooks. “Especially those who have had a hysterectomy or are postmenopausal. And especially knowing that women in particular are having symptoms the month before.”
Heart disease is genetic, but there are other risk factors as well. Smoking and obesity increase chances of heart attack, and men and women alike are both recommended to make heart-healthy decisions in their daily lives. “It is all the same things we have always told people,” says Middlebrooks. “Keep your yearly appointments, quit smoking if you are smoking, modify your diet, go out for a walk.”
For women specifically, Dr. Shirey recommends, “The biggest message I would convey to a woman would be that she treat herself as she would the rest of her family. If her health needs are not being met, she is not going to be able to maintain everyone else’s needs.”