Here’s a news flash from the Department of the Bleedin’ Obvious . . . Medical researchers tell us that married men suffering heart attack chest pain get to the hospital far quicker than single men do. In my admittedly non-scientific opinion, this reality is entirely due to the fact that these married men have wives.
As Dr. Ralph Brindis, past president of the American College of Cardiology, once told a Wall Street Journal interviewer:
“Thank God we have spouses. I can’t tell you how often, if it was left up to the patient, they never would have sought care.”
According to one study, for example, a Canadian research team out of Toronto’s Institute for Clinical Evaluative Sciences found that the odds of men showing up at the hospital more than six hours after the onset of cardiac chest pain were a relative 65% lower in men who were married or in common-law relationships.
In a spectacularly understated explanation for these findings, researchers reported in the Canadian Medical Association Journal:(1)
“We surmise that, in general, women may be more likely than men to take the role of caregiver and to advise their spouses to seek early medical assessment.”
This early medical assessment during a heart attack is crucially important, because we know that half of the deaths from a heart attack occur in the first 3-4 hours after cardiac symptoms begin. Now here’s the interesting – and utterly maddening – part of this surmising from the Canadian study: a similar association was not seen in married women. In other words, being married did not mean that women were more likely than their single peers to seek faster help in mid-heart attack.
Are these odd findings due to the fact that married women are not being encouraged to seek help by our spouses, or is it that married women are choosing not to heed this advice?
Here’s my take on how the Toronto scenario might theoretically play out:
John: “Oh, no. I’m having horrible pressure right in the middle of my chest…”
Marsha: “WHAT?!? You don’t look so good, dear. I’m calling 911 right now!”
Contrast this heart attack scenario with another episode, but this time, picture that it’s the wife experiencing heart attack symptoms instead of her hubby:
Marsha: “Oh, no. I’m having horrible pressure right in the middle of my chest… “
John: “It could be the fish you made for dinner tonight. I thought it smelled a bit off.”
Marsha: “Oh!! Now it’s spreading down my left arm . . . “
John: “Well, you were working pretty hard digging in the garden this afternoon. Have you seen that damned remote? The game’s going to be starting any minute…”
Marsha: “Is it hot in here, or is it just me? I’m sweating like a pig!”
John: “Probably just another of your hot flashes.”
Marsha: “I’ll get the remote for you. It’s right over . . . OH! OH!!!” (collapsing onto the couch)
John: “It’s right over where? Where is it? I’m missing the national anthem!”
Marsha: “Oohhhh! Ooooooh!” (slipping down onto the floor, clutching left shoulder)
John: “Can you see it? Did it slide under the couch?”
Marsha: “I … I … I’m just gonna lie down here for a minute . . . Can’t. Catch. My. Breath . . . “
John: “Oh, never mind, honey! I found it! Here it is! Aha!! Just in time for the puck drop! “
John: “Honey, what’s with you? Do you need help?”
Marsha: “Huh? Oh . . . No. No. It’s. Probably. Nothing . . . I’ll. Be. Okay . . . “
And that, my heart sisters, is what we’re up against. The Canadian researchers suggest that while being married was strongly associated with a significantly lower likelihood of waiting too long to seek help after the onset of chest pain, this relationship was statistically significant in married men only – not in women, married or not.
According to the Texas Heart Institute,
- heart attacks are generally more severe in women than in men
- in the first year after a heart attack, women are more than 50% more likely to die than men are
- in the first six years after a heart attack, women are almost twice as likely to have a second heart attack compared to our male counterparts
With stats as grim as this, why do women wait longer to seek immediate help in mid-heart attack despite the very real risk of ignoring the “Time Is Muscle” warning of all cardiologists? The longer we wait before seeking emergency help to re-open blocked coronary arteries, the more we risk damaging the heart muscle.
As I wrote here, Oregon researchers have identified six types of what they called “treatment-seeking delay” behaviour among women who were experiencing a heart attack.(2)
These six patterns of behaviour choices happened between the time that women first know they are experiencing serious cardiac symptoms and the time when they go for help. For example:
knowing and going (women acknowledged something was wrong, made a decision to seek care, and acted on their decision within a relatively short time, typically 5-15 minutes)
knowing and letting someone else take over (women told someone they had symptoms and were willing to go along with recommendations to seek immediate medical care)
knowing and going on the patient’s own terms (women wanted to remain in control, were not willing to let others make decisions for them, and openly acknowledged that they did not like to ask others for help – these are the women who drive themselves to Emergency!)
knowing and waiting (women decided that they needed help but delayed seeking treatment because they did not want to disturb others)
managing an alternative hypothesis (women decided symptoms were due to indigestion or other non-cardiac causes, and were reluctant to call 911 “in case there’s nothing wrong and I’d feel like a fool” – until their severe symptoms changed or became unbearable)
minimizing (women tried to ignore their symptoms or hoped the symptoms would go away, and did not recognize that their symptoms were heart-related)
During my own epic treatment-seeking delay experience, I spent two weeks perfecting #2, 3, 4 and 6 before ultimately going for help when my symptoms became unbearable (as in #5).
Women – married or otherwise – must make better decisions about seeking emergency medical help for any symptoms that make you suspect you might be having a heart attack.
Despite our documented tendency to ignore or dismiss serious symptoms, try imagining what you’d decide to do if it were your husband experiencing the identical symptoms – and then do the same thing for yourself!
(1) Atzema C, et al “Effect of marriage on duration of chest pain associated with acute myocardial infarction before seeking care.” CMAJ 2011; DOI: 10.1503/cmaj.110170.
(2) Anne G. Rosenfeld et al. “Understanding Treatment-Seeking Delay in Women with Acute Myocardial Infarction: Descriptions of Decision-Making Patterns.”Am J Crit Care July 2005 vol. 14 no. 4 285-293
- ‘Knowing & Going’ – Act Fast When Heart Attack Symptoms Hit
- Why We Ignore Serious Symptoms
- Poor Marriage = Poor Heart Health For Women
- Women Heart Attack Survivors Know Their Place
- Marriage Triples our Bypass Surgery Survival Rates – But Only if it’s Happy
- When Being Married Makes Being Sick Worse
Q: Do you think married women are not being encouraged to seek emergency help by their spouses, or is it that women are choosing not to heed this advice?