Archive | November, 2009

“Women’s Heart Attack Myth”? Revisiting the controversial Canadian study

28 Nov

heart man woman cards

Media coverage of a study presented at the annual Canadian Cardiovascular Congress last month has left me and my fellow Heart Sisters gobsmacked.  One heart attack survivor told me:

“This ‘research’ has set back women’s awareness of heart attack symptoms by a full decade!”

What could have inspired a reaction like this?  First, there are the media headlines, “The Heart Attack Myth”. Second, there’s the research methodology (the way this study was designed). And finally there’s the reporting of the study’s conclusion:  essentially, that there are no differences in heart attack symptoms between men and women.

This study looked at 305 patients undergoing routine, scheduled, non-emergency angioplasty* procedures in hospital. Based on cardiac symptoms that patients reported during the momentary full blockage while the angioplasty balloon expands inside the coronary artery (ostensibly imitating what happens during an actual heart attack) the study’s conclusion is that women experience the same chest pain symptoms that men do during a heart attack. Oddly enough, media coverage rarely touched on another of the study’s key findings: that women in this study suffered “significantly more throat, neck and jaw pain” than men. Tragically, this omission is a missed educational opportunity.

Scratch any heart attack survivor and you’ll likely uncover an amazing litany of weird symptoms – some so weird you’d never believe them to be remotely cardiac in nature.  Lips turning numb, persistent coughing, elbow pain, earache, heavy sensation in the hands, vomiting, fever – do these sound like heart attack warning signs to you?  Yet these and many other relatively unfamiliar symptoms are reported by women every day during real-life heart attacks. These unusual symptoms are important to know because up to 40% of women report no chest symptoms at all during a heart attack.

Since I started doing public presentations about women and heart disease, it’s been an uphill battle to convince women of the need to recognize and respond immediately to heart attack symptoms – ALL symptoms. These may include the textbook sign of chest pain (as I experienced myself during my own heart attack) but also include many vague symptoms that women report. I have yet to meet any woman who is unaware that chest pain is linked with heart attack, but many are very surprised to learn about less common symptoms.  If only media coverage of this study had featured women’s commonly experienced throat, neck, and jaw pain symptoms as the major headline, instead of the catchy but misleading “Heart Attack Myth”. (more…)

Mayo Clinic: “What are the symptoms of a heart attack for women?”

26 Nov

It’s been in the news. It’s been presented at cardiology conferences this month.  It has set cardiac circles and women heart attack survivors abuzz. It’s the question of whether women present with heart attack symptoms that are different than those of men.  For answers, let’s visit the website of the world-famous Mayo Clinic:

“What are the symptoms of a heart attack for women?”

“The most common symptom of a heart attack in both men and women is some type of pain, pressure or discomfort in the chest. But it’s not always severe or even the most prominent symptom, particularly in women. Women are more likely than men to have signs and symptoms unrelated to chest pain, such as:

  • Neck, shoulder, upper back or abdominal discomfort
  • Shortness of breath
  • Nausea or vomiting
  • Sweating
  • Lightheadedness or dizziness
  • Unusual fatigue

“These signs and symptoms are more subtle than the obvious crushing chest pain often associated with heart attacks.  (more…)

A post-heart attack checklist

24 Nov

You’ve just experienced a heart attack or other type of cardiac event.  You’re overwhelmed and frightened and wondering what happens next on this journey towards recovery. Knowledge is power – here’s when you need to take charge of that recovery by learning everything you possibly can about your heart health. Complete this important checklist to make sure you are on the right road.

1. Lifestyle changes:

  • I have been fully instructed on the warning signs and symptoms of heart attack, and the actions to take if I experience any of these signs or symptoms again. (yes/no) _____
  • If I am a smoker, I have been told to stop, and referred to one or more smoking cessation programs. (y/n) _____
  • I have learned about heart healthy eating to improve my diet from now on (y/n)_____
  • I have received detailed activity instructions for the next 4-6 weeks, and have been referred to a cardiac rehabilitation program. (y/n) _____
  • I have been told about how common post-heart attack depression can be, that it is treatable, and that I should report early signs to my physician for help (y/n) ___
  • The importance of daily exercise has been explained to me. (y/n) _____
  • My doctor has talked to me about when I can go back to work. (y/n) _____
  • My doctor has talked to me about when I can resume sexual activity. (y/n) _____
  • My doctor has talked to me about when I can resume driving. (y/n) _____

2.  Assessing the risk of another heart attack in the near future:

  • The status of my coronary arteries has been assessed by either stress/thallium study (y/n) _____ or cardiac catheterization/angiogram (y/n) _____
  • The condition of my coronary arteries has been explained to me as follows: __________________________________________________________________________
  • The plan for following the status of my coronary arteries over time is: __________________________________________________________________________   (more…)

The busy woman’s guide to surviving a cardiac event

22 Nov

Eliz Greene is a woman who knows what she’s talking about when she describes surviving a heart attack.  She was seven months pregnant with twins when she suffered a massive heart attack. Not only did she survive a ten-minute cardiac arrest, the caesarean delivery of her daughters and open heart surgery –  all on the same day! – she gained  new perspective and passion for life. (more…)

Women missing the beat: are doctors ignoring women’s cardiac symptoms?

20 Nov

woman mirror

True or false?  Every year, more women die of heart disease than men.

The answer is true, but if you didn’t know it, you’re in good company. In a survey of 500 American doctors (100 cardiologists, 100 obstetrician/gynecologists, and 300 family practice physicians) led by cardiologist Dr. Lori Mosca, only 8% of family doctors knew this fact, but – even more astonishing - only 17% of cardiologists were aware of it.

When it comes to women and heart disease, ignorance can be deadly. The misconception that heart disease is mostly a ‘man’s disease’ is one reason that women continue to be misdiagnosed or receive delayed treatment when experiencing symptoms of heart disease.

De Lori MoscaDr. Mosca, Professor of Medicine and Director of Preventive Cardiology at NewYork-Presbyterian Hospital/Columbia University Medical Center, explains that women patients often report that their complaints were dismissed or that they were “blown off” by their doctors when they presented with heart disease symptoms. Studies show that there is a gender bias out there that women need to be aware of.

” Our own research has shown that physicians are more likely to label a woman at lower risk for heart disease than a man with the same calculated level of heart disease risk.”  (more…)

Physical exercise vs. the ‘plumber’s pipe’ theory of heart disease treatment

18 Nov

plumber pipes

A billboard in cardiologist Dr. William Bestermann‘s hometown of Kingsport, Tennessee is sponsored by a local hospital there. It recently proclaimed: “More procedures equal better outcomes in heart disease”. So, he explains, the public in Kingsport likely understands coronary artery disease to be a progressive blockage, like hard crusty scale building up in a plumber’s pipe. And thus the more procedures, the more treatment, the more technology you can throw at coronary artery disease, the better. Dr. Bestermann adds:

“The current system of cardiac care works like this: even if a patient has a 60% blockage of a coronary artery, it does not interfere with blood flow. It does not cause chest pain or other cardiac symptoms. The patient is thought to be safe, and nothing much is done for or to the patient.

“But if the blockage is 70% or greater, it begins to interfere with blood flow. It may cause some pain or other symptoms. The patient is thought to be in danger, and this level of disease activates our entire health care system of treadmill stress tests, cardiac catheterizations, implanting stainless steel stents and doing open heart bypass graft surgery. A 100% blockage is a heart attack, but if we can catch the blockage before it becomes 100% and open it with a bypass or a stent, then we have saved the patient from having a heart attack. This is the way most patients and physicians currently understand the problem of coronary artery disease, and it is the way our current system operates.”

But Dr. Bestermann maintains that our current cardiac treatment does “too little, too late”. In cardiovascular disease, the care model is built entirely around opening blockages in patients with late disease, which can relieve symptoms, but does not prevent heart attack.  Find out how a heart attack happens …

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