Heart disease kills more women than all cancer combined

The Heart Truth logoThe first time it happened, I was at the meat department in Raley’s. I started to feel funny, in an unfamiliar way. It wasn’t a pain so much as a sense of fullness in my chest, and it scared me.

The health news of late had been focusing on new research that the symptoms of heart attack are different for women than for men. For years, it had been a one-size-fits-all warning: chest gripping, crushing heart pain and aching left arm–heart attack! Except that women’s angina they now said was not like that at all. For women, it could just be an aching neck or overwhelming fatigue or nausea or–.

I’m thinking all this as I’m standing by the coldcase of sirloin and chopped beef wondering whether this funny feeling, this new-to-me sense of fullness in my chest is my version of a heart attack. I move out of the meat department and down the cereal aisle, trying to ignore the myriad thoughts racing through my mind: Yes. No. It is. It isn’t. I’m being silly. I’m being proactive.

But now, now I’m aware that my arm does ache and I’m having trouble breathing. I feel as if I can’t get enough air in. And I’m starting to feel lightheaded, and kind of cold, clammy actually. And tingly. I’m definitely starting to feel tingly.

Should I go to the ER? Yes–I might be having a heart attack and they’ll save my life. No–you’ll just end up sitting in the waiting room for hours feeling foolish. Yes, no, yes, no. Finally I arrive at a compromise. I’ll go to my doctor’s office, which is only a short drive away. I leave my half-loaded cart in the cereal aisle–.

The doctor does an EKG, pronounces my heart healthy and I return to Raley’s to finish shopping, feeling foolish.

The same thing happened again several years later, on Christmas Day. But this time Dennis is with me and he, who lived through the days of my ruptured cerebral aneurysm, drives me to ER. There I spend about 4 hours having every kind of test imaginable and am told, again, that my heart seems fine. This time, I not only feel foolish, I’m out $3000 because the ER doesn’t take my insurance. (Thank you, Kaiser Permanente).

My story is a classic example of that adage, “a little learning is dangerous.” The National Heart Lung and Blood Institute’s (NHLBI) education program, The Heart Truth®, has done an excellent job in alerting women to their cardiac vulnerability, but the symptoms of angina they list are, to my overactive imagination, too general.

Nausea, back pain, jaw pain, sweating, shortness of breath and inordinate fatigue–these are facts of life in many women’s day-to-day physical being. Is there any way to know when these symptoms should be seen as indicators of heart attack? Is there any way to know when it’s time to call the doctor–or just put your feet up with a cup of tea.

I put those questions on this,  the ten year anniversary of  The Heart Truth® program, to Nakela L. Cook, M.D., M.P.H., F.A.C.C., a medical officer in the Clinical Applications and Prevention Branch in the Division of Cardiovascular Sciences at the NHLBI. While agreeing that the symptoms of angina can be similar to those of anxiety, she offered this advice about when it should be taken more seriously:

  • when the symptoms are different from what you’ve felt before
  • when they’re stronger, more intense
  • do they last longer or do they go away and then return
  • are they associated with physical activity
  • do they come together in a constellation 

Bottom line, however, according to Dr. Cook is that often physicians can’t tell whether someone is having a heart attack either. “There are other conditions in addition to anxiety attacks that can present similarly to heart disease,” she said. “So what we are trying to do with the physical workup is to rule in or rule out all other conditions. We have to play it safe, take the symptoms seriously and find out what is really going on.”

The Heart Truth® campaign has been successful, Dr. Cook added, in that 54% of us now know that cardiac disease is the leading killer of women. Those women are more likely now to take positive action such as losing weight and eating healthier. However, the campaign’s work is not over by a long shot. “Women are just not as good about getting help for themselves as they are for those they’re taking care of. You have to be the empowered individual in your life in order to have a good outcome for yourself and your family.”

Women of color are at particular risk, according to Dr. Cook. They have a greater burden of risk factors such as high blood pressure, obesity and diabetes than white women. In addition, “women of color often don’t receive the same treatment as the standard of care so the outcomes for them are not as good.”

For all women, however, the gender disparity in cardiovascular disease is the reason why more of us will die of heart disease than from all forms of cancer combined. Now that’s a scary statistic–but it’s one that we as individuals can do something about. How’s your heart health?

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  • Linda D’Ae-Smith

    Sorry about the $3K (we have Kaiser, too – husband’s employer), but better to be cautious. My (very healthy, exercises five days a week, looks more like 65 than 81) mother-in-law had a heart attack with no “classic” symptoms -just a little nausea and she felt feverish. Took more than a week to correctly diagnose, but the short story is that she had a 90 percent blockage in one artery and a 60 percent blockage in another.

    • http://midlifebloggers.com janegassner

      This story is so scary, Linda. It’s almost like ‘no matter what you do…’ which isn’t a great attitude, I know. I hope you mil is okay now.

  • Morgana Morgaine

    Heart disease is admittedly a female worry now that we seem to have caught up with men. However, I think there is always so much to be gained by taking all human experiences up an octave and asking what is this really about? Heart disease is a symptom, me thinks! If we spend more energy telling what is true for ourselves, weeping real tears about real events on the planet, encouraging the expression of grief in men and women so that we move energy and the mountains of feelings that pile up, and never again stuff down who we are or try to control another’s destiny politically, socially, or spiritually….we just might move beyond the “what to eat and how much exercise to “get” level of living peacefully with this incredible powerful organ, the heart!

    • http://midlifebloggers.com janegassner

      Morgana,
      I agree with you about the heart-mind connection. How we live emotionally is an equal partner in our physical well-being as how we live physically.

  • ccassara

    This is such a great public service–great points and good information every woman our age should be aware of.

    • http://midlifebloggers.com janegassner

      Thanks go to our federal government as well for sponsoring all the research and the information program that led to this post.

  • Pat

    Thanks for the great reminder, Jane. As women, in many ways, we are taught to minimize our own physical pains in our role supporting others. Perhaps as more women join the ranks in medicine, our voices will be heard!

    • http://midlifebloggers.com janegassner

      I used to think that gender made a huge difference in how the doc treated me, but now I’m not so sure. I’ve had some male docs who took all the time in the world and listened to me; I’ve had some female docs who have not.

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  • longhollow

    What a wonderful post and great reminder. I think you were wise to go get it checked, although I’m sorry the second one cost you so much. But I’m glad you were okay! A friend of mine from high school died three years ago, at 50, from a heart attack. Sudden, no previous symptoms that anyone knew about. She was thin and looked healthy and her parents are still alive and well. I think it’s better to be overcautious.

    • http://midlifebloggers.com janegassner

      I have a friend who had a heart attack in her forties. She too was thin and exercised diligently. Fortunately, she got to the hospital in time.

  • Linda Hoye

    A good reminder, Jane. A co-worker of mine (male, under age fifty) had a heart attack early on Christmas morning. His symptoms were not what one thinks of as “classic” either. We hear of these things so often. The best defense is a good offense in terms of a healthy diet, appropriate levels of exercise (I know, ugh), and reducing stress.

    • http://midlifebloggers.com janegassner

      Yes, ugh to exercise, Linda. I so wish I was one of those people who just LOVED LOVED LOVED it.

  • http://myathleticlife.com/ Tim Huntley

    Jane,

    In reading your story, and had those symptoms to happened to me, I would have been in the ER ASAP – I know $3000 is a lot of money, but what if it had really been a heart attack? My Dad had one about 3 years ago, and he was home alone. He was extremely lucky and could have easily died, but somehow he was able to get to the phone and call his sister.

    …Tim

    • http://midlifebloggers.com janegassner

      Tim,
      Thanks for your encouragement. I think your response speaks to the gender disparity in health care. Men have the reputation of not going to doctors when they should, and women are assumed to be over-attentive to their health. I so don’t want some doctor thinking I’m another whiney woman that I tend to downplay my symptoms. Funny thing, though–when I had that ruptured cerebral aneurysm, the paramedics and the ER docs at first dismissed me as just another middle-aged woman with a migraine. Ha!

  • http://twitter.com/GrownandFlown Grown and Flown

    Jane, it is a good reminder any day of the year! So much more attention seems to be focused on breast cancer than heart disease – and what can be done to prevent it. Thank you and take care.

    • http://midlifebloggers.com janegassner

      Yes, the noise has been louder for the Pink Ribbon crowd, but I think the Red Dress is catching up.

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