We've all heard the warnings, heart attack is different for women. Yet so many doctors and women themselves remain in the dark about this epidemic. Breast cancer which effects one in eight to eleven women, has deservedly received a lot of press yet the fact remains, one in two people, men AND women alike will die of heart related problems!
The signs and symptoms of heart problems or coronary artery disease do not usually sneak up on you all of a sudden. We are so used to seeing in movies or on television, an obese man in his 60's eating a huge fat laden dinner suddenly clutch his chest and collapse that we fail to recognize heart symptoms that are much less obvious, yet just as dangerous.
I am a 50 year old woman. I do not smoke. I am only slightly overweight. I eat very well, with virtually no fast foods or soda in my diet. My cholesterol is perfect, with my LDL low and my HDL nice and high. I exercise daily. I have no family history of heart problems nor do I have high blood pressure. Yet, in the last two years I have experienced three completely blocked arteries and undergone angioplasty and stent placement. After each episode I went to cardiac rehabilitation, and ate even better. I took all my medications.
Inevitably, when people hear about my experience they anxiously ask, "What did it feel like"? Everyone wants to know what to expect if they find themselves in the same situation. First of all, I learned by experience and from my nurses that the number one best indicator that something is wrong actually comes on quite early. You will find that you just cannot tolerate as much activity as you used to. Whether it's climbing a flight of stairs, working out at the gym, or walking the dog, your normal everyday activities will start to feel much harder. You'll think, 'Wow am I out of shape? I have to exercise harder or longer!' Next you will find you simply cannot exercise or even take walks and eventually the crushing sleepiness will set in. You may feel the need for naps, or get overwhelmingly tired while driving. After dinner, and then earlier, you'll just feel wiped out, exhausted. This symptom can last for many months becoming worse as valuable time goes by.
For many relatively young women in our culture, tiredness has become such a common complaint, that many doctors ignore this potential early sign of heart problems and prescribe sleep, exercise or worse, anti-depressants. They may try to diagnose you with "anxiety" or panic-attacks. I am one of the calmest people you'll meet, I've never had anything remotely resembling a panic attack, but that's what many doctors are trained to look for and even expect from women. They want to help, so they give you a pill and send you on your way.
However, for many women, these overly tired symptoms can mean that your artery is slowly closing, each day becoming more blocked with plaque and less able to allow blood to flow through. Next, for many women comes some measure of pain. For me, it started on a Friday morning as a neck ache, on the left side. You know that feeling as if you've slept wrong? For a day or two that pain got worse, then on Saturday it included my shoulder and then the upper arm. At the gym, after about ten minutes on the bike, my hand got numb so I stopped exercising and took a short rest. I tried again, this time on the elliptical machine but my hand got tingly after only five minutes so I left, by this point, getting scared.
The next day was Sunday and I attended a family picnic. I was tired and at one point nearly passed out and my arm hurt like crazy. I rubbed it and started sweating. My husband took me to the emergency room and here's the problem. Because I hadn't actually had a heart attack, my blood didn't show the enzymes necessary for them to diagnose me properly. When you have a heart attack, when there is actual damage to the muscle, enzymes called creatine kinase (or CK) are given off by the damaged muscle and can be detected rising for a period of time before leveling off and then decreasing. These enzymes are the classic marker of a heart attack. Unfortunately, these tests are limited in that if there is no damage yet, they do not show up and you may be sent home.
I was scheduled for an electrocardiogram the next day, Monday. They did the test and sent me home again. By now my pain was constant, my arm hurt, my chest hurt. I couldn't lay down it hurt so much, but I figured the doctors would call if the tests showed anything. Wednesday morning against his better judgment, my husband went to work. I sat on the couch crying and clutching my pillow. My teenage son was looking on the Internet and he said, "Mom I think it's a heart attack. It says here they don't listen to women, you better go back." (to the hospital) Finally, I called my husband to come home and take me back one more time to the emergency room. Finally my CK levels were up and they confirmed our fears, a heart attack.
I was lucky. There was no permanent damage to my heart, and the next two times I experienced similar symptoms, I went to a different hospital and they kept me long enough to get the definitive blood tests. Moral of this story, you know your body best. For women especially, keep these progressive symptoms in mind:
1. You feel overly tired. Exhaustion, difficulty with activities that used to come easily.
2. Pain or soreness on the upper left side of the body, especially the neck, shoulder, or upper arm
3. Numbness or tingling of the left arm and/or hand.
4. Pain in the chest.
A little prevention goes a long way as well. Know your cholesterol levels. Know your family history, if you smoke, stop. This is important information the emergency room staff will need and if you can give them accurate answers they can diagnose the problem faster. Most importantly, do not underestimate your pain, as many women tend to do. It's better to be wrong and have a false alarm than to take a chance with this all too common women's health issue.