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My name is Kristin, and I work at ASHA's national office. Two years ago, I had a heart attack at the age of 39. Since then, I've learned a lot about women and heart attacks. What I've learned has shocked me, so much so that I wanted to share my story with ASHA's membership.
Here's how it happened with me. I fell asleep in a hotel room and woke up with an ache between my shoulder blades. "Bad mattress," I thought and popped a couple aspirin. The pain continued intermittently for about a week, and I even got a sports massage, thinking I must have irritated the muscles in my back. Then, other weird things started to happen.
I would walk up an incline and get a sensation of being winded and yet I wasn't out of breath. I had slight squeezing sensations in my chest that lasted briefly, 10 to 20 seconds tops. I know what you're thinking, "Why didn't she see a doctor?" but the sensations were so very slight. Besides, you know how it goes. I had things to do, the aspirin took care of the pain, and we all hate going to see the doctor. I never really thought that this was the beginning stage of a heart attack.
Then one night, about two weeks after the initial upper backache, that squeezing-being-winded-but-not-out-of-breath feeling woke me up in the middle of the night. Still, it didn't last very long and it caused no pain. It was just unnerving. I've since learned that what I was experiencing was stable angina that had progressed to unstable angina-a known signal for the onset of a heart attack. Did you know you could have symptoms before you have a heart attack? I didn't, and I certainly didn't think these symptoms could last for two weeks!
For some reason, when I picture a heart attack, the image of Fred Sanford from the TV show "Sanford and Son" pops into my head-a man clutching his heart, staggering and saying, "I'm coming to join you, Elizabeth!" This, I've learned, is what's known as a "Hollywood heart attack," and it's dangerous for people to think that this is the only way a heart attack can happen.
I went to work and told my friend and co-worker, Leah, what had happened that night. She was much more concerned than I was, so much so that she kept putting little notes over our connecting cube wall saying "See your doctor - NOW!" I made an appointment for the next day, but her sense of urgency got to me, so I called the 24-hour nurse line available through our insurance.
I answered a series of questions and was quite surprised when the nurse said, "Get to the hospital now, you're having classic signs of a woman having a heart attack. Would you like me to call an ambulance?" I was stunned because I felt fine. I could drive. I could work. Heck, I was scheduled for another massage later in the day and, frankly, I was looking forward to it.
Leah drove me to the hospital, where I had a series of tests in the emergency room including an EKG, tests for a certain protein in my blood, and a chest X-ray. When I told one of the doctors that the nurse I talked with on the phone said I was having classic signs of a heart attack, he dismissed it-saying I was probably suffering from acid reflux.
Hello? After just typing "heart attack" on WebMD and seeing the symptoms for unstable angina, I could have diagnosed what was happening to me (see About Angina). Warning, ladies: A study published in the Journal of the American Medical Association and conducted by Mayo Clinic researchers showed that women who went to the emergency room with unstable angina were 24% less likely than men to be tested for heart attacks or heart disease. Another study published in the American Journal of Cardiology again showed that women in emergency rooms were less likely to be tested for a heart attack or heart disease. What's more, the second study found that women were also less likely than men to receive lifesaving medication or surgery after being diagnosed. With heart disease and heart attacks so common in women, you'd think doctors would be on the alert for their symptoms. But experts say that many women aren't being diagnosed and treated as quickly as men with the same conditions.
Fortunately, this was a good hospital and there was a team of cardiologists treating me instead of this one doctor. They wanted to do a stress test on me in the morning and thought it would be best if I stayed overnight. I was very disappointed, but I settled into my bed, watched some TV, and called a couple friends. I had been given some nitroglycerin in the emergency room, and I was told it would probably give me a headache, which it did. I used to have migraines back in college, but I hadn't had one in years.
Whew! This one was a doozy. I asked a nurse to stay with me since in the past, if I (sorry to get gross here) vomited during a migraine I was otherwise okay. But this time I wasn't okay; in fact, the vomiting got out of control, which was completely unexpected. And then it happened, stabbing pains right in the center of my chest. I did clutch my heart but quite honestly it was my upper back that hurt the most.
Suddenly, my room was filled with people. One did an EKG and told me I was having a heart attack. What? I was in pain, but a heart attack? Really? I had to sign some papers for a "procedure" (my mind was racing-was I going to have scars from open heart surgery?).
I was given lots of morphine and, after what seemed like quite a long time (but probably was only half an hour at the most), I was taken to a special room and placed on an operating table where a catheter was placed in my inner thigh. The catheter ballooned in my artery, slightly enlarged it, and dislodged the blood clot that was blocking it. I fell asleep immediately. The morphine put me into a warm, cozy, pain-free doze. This procedure is called an angioplasty, and it can prevent a heart attack as well as save you from one.
Later, when I asked my cardiologist if it was unusual for a 39-year-old woman to have a heart attack, he said "not that much." If you were to meet me, you'd never know I had any kind of health issue at all.
But my massive myocardial infarction (heart attack) killed 10% of the muscle that is my heart. I have to take seven pills a night, visit and be tested by my cardiologist every three months, and live with the knowledge that my chances of having a heart attack in the future have seriously increased. Still, I know, I'm extremely lucky. What if I'd ignored Leah's advice and the heart attack had happened while I was driving home?
So, here is the the message that my friends, co-workers, and supervisors at ASHA (with the generous support of Subaru of America and Marsh Affinity Group Services) are most graciously helping me bring to you. Be your own heart health advocate. Talk to your doctor, and make sure every medical professional treating you takes your heart health concerns seriously. Do a little research. Know your numbers (blood pressure, body mass index, cholesterol, and blood glucose). Know your risk factors. Know your body and trust your instincts.
I was lucky. You can be smart. If you read this information and follow up with the additional resources, you can empower yourself and watch out for the women in your life, just like Leah did for me.
Heart disease: It's the #1 killer of women. But if you ask the woman on the street, young or old, what health problems she's worried about, heart disease rarely makes her list. Most people's vision of a person with heart disease is an older man or a gray haired granny. Heart disease is just not something most women think is going to happen to them-and if it does, it won't be for decades… but these women are wrong.
Source: WomenHeart: The National Coalition for Women With Heart Disease
"Many women are so busy working and taking care of their families that they put their own health needs last. Women just don't come to the emergency room soon enough and often don't take their symptoms seriously. There is much that a woman can do to avoid becoming a heart disease statistic. This is especially true for younger women."
Dr. Alexandra Lansky, Cardiologist
Lenox Hill Hospital, New York City
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