Heart Attack Symptoms More Subtle In Women

Heart disease is No. 1 killer of women

Mary Lacina of Davenport had some tightness in her throat that wouldn’t go away. She thought it might be anxiety.

She felt worse by the next morning. After a sip or two of her morning coffee and with the tightness intensifying, she swallowed some aspirin and had her husband drive her to the hospital. She was clutching her chest by the time she arrived at the Genesis Emergency Department registration desk.

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Darla Lowe’s upper arms ached. She took a Tylenol and sat down to watch a movie.

When her shoulders and neck also began to hurt, Lowe of Park View figured she had pulled a muscle while lifting a bag of quarters at her job. It wasn’t until four hours after her first symptom that she called her daughter to take her to the hospital.

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Both women began with seemingly harmless symptoms that ended in a heart attack.

Both were rushed to the Cardiac Catheterization Lab, where cardiologists opened up their blocked arteries and inserted metal stents to restore blood flow to their hearts.

United by heart disease, the two became friends and now share a commitment to exercise in Phase 4 Cardiac Rehabilitation at the Genesis Heart Institute.

“My heart attack was a big shock,” Lacina says. “The day before, I felt tightness in my throat at work, and my co-workers said, ‘You should go to the hospital.’ Instead, I went to my car over lunch, took a nap and felt a little better. The next morning, however, I woke up with the same thing. It just got worse.”

Lowe was baffled by the pain in her upper arms as she watched TV. The prospect of a heart attack never entered her mind -- until her jaw began to hurt hours later. “I could still talk and breathe just fine. I thought I had pulled some muscles.”

Listen to your heart Today, in celebration of the American Heart Association’s National Wear Red Day, their experiences remind women that cardiovascular disease is not just a man’s problem.

• More women die of heart disease than the next three causes of death combined, including all forms of cancer.

• Currently, some 8 million women in the U.S. live with heart disease, yet only 1 in 6 American women believes heart disease is her biggest threat.

• In women, heart disease is too often a silent killer. Less than a third of women in a recent survey reported any early warning signs like chest pain or discomfort before a heart attack, compared with most men.

• Heart disease is the No. 1 killer of women age 20 and over.

Mary Lacina had sleep apnea and high cholesterol, both risk factors for heart disease. Before her heart attack at age 54, she experienced arm and leg pain and was taken off her cholesterol medication to determine if that was the cause.

After her heart attack, she was diagnosed with diabetes in the hospital. She resumed her cholesterol medication. After another sleep apnea test, the settings on her Bi-PAP machine were changed to help her overworked heart.

Darla Lowe also had risk factors before her heart attack at age 64. She had been on cholesterol-lowering and blood pressure medications for 20 years. She was a lifelong smoker and had diabetes. Women with diabetes have a 3-to-7 times greater risk of heart disease and heart attack. Still, she didn’t connect her upper arm pain with a heart attack.

“Awareness is improving, but many people still don’t think heart disease is a woman’s problem,” says Karen Doy, Supervisor of Cardiac Rehabilitation at the Genesis Heart Institute.

“Women frequently continue activities when they feel ill. They don’t see their symptoms as serious or realize they represent a heart condition.” Women tend to have heart attacks later in life than men, and as a result, often have other diseases that can mask symptoms. Oftentimes, heart attacks in women go unnoticed or unreported because their symptoms are more subtle than men’s.

“Women often don’t have the ‘classic’ chest pain that grips the chest and spreads to the shoulders, neck or arms,” Doy says. “Instead, they have a greater tendency to have atypical chest pain or to complain of abdominal pain, difficulty breathing, indigestion, nausea and unexplained fatigue.”

“Sometimes, their only symptom is extreme fatigue,” adds Brenda Youngs, R.N., a charge nurse for Genesis Cardiac Rehabilitation. “Many women think fatigue is just a normal part of living. We encourage people to consider that any pain from the nose to the belly button might be heart-related -- until it’s ruled out.”

Women should learn the signs of heart attack and change the risk factors they can change, Youngs adds. Be more active. Lose extra weight. Stop smoking. Manage diabetes. Control your cholesterol and high blood pressure. Limit alcohol consumption. Be your own best health advocate.

Cardiac rehab

Today, Mary Lacina and Darla Lowe lead a healthier lifestyle with each other’s help.

Three times a week, they exercise together at the Genesis Heart Institute gym. They met after their heart attacks and grew to appreciate having medically supervised exercise in Phase 2 Cardiac Rehab and the support of others who also had heart disease. They stayed on for Phase 3 and 4.

“When I started Cardiac Rehab, I was petrified to do anything physical,” says Lowe, who has quit smoking since her heart attack. “But staff at Genesis were really, really great. Phase 2 taught me to move again. Now, I actually look forward to exercising, perspiring and feeling muscles again I had forgotten I had.”

Both agree exercising together has been key to their success.

“The truth is, I wouldn’t be exercising if I didn’t attend this class,” says Lacina, who received two stents after her heart attack. “Having a heart attack is a lifechanger. You have to become more active. You can be at Cardiac Rehab for that hour, and the time is yours.”

Since she joined Cardiac Rehab, the results of her echocardiogram have greatly improved over seven months.

“Trust your instincts,” she concludes. “If something doesn’t feel right, it probably isn’t.”