by Carolyn Thomas   ♥   @HeartSisters

Every February is Heart Month – when facts and stats about heart disease flood our screens. But Heart Month facts and stats are so pre-COVID – when we also learned the truly discouraging results of the latest American Heart Association (AHA)’s national survey.  This survey found that women’s awareness of heart disease actually DECLINED over the previous decade – despite all the inspiring Red Dress fashion shows/awareness-raising/Go-Red-for-Women campaign efforts out there. So instead of repeating more scary statistics as if I hadn’t read that survey’s results, this time I’m simply offering some weird stuff I’ve learned over the years about women and heart disease:    .            

1.  Weirdest example of the cardiology gender gap:  This 2018 study tracked four years of National Emergency Medical Services Information System data. Researchers found that female heart attack patients who had been transported by ambulance to the Emergency Department after calling 911 for help were less likely than male patients to receive recommended cardiac treatments en route (even aspirin!) – and also significantly less likely to have the ambulance sirens or flashing lights turned on. 

2.  Weirdest heart attack symptoms in women:

• “My lips went numb”
• “My only cardiac symptom was a persistent cough”
• “My bra felt too tight.“

3.  Weirdest husband-and-wife heart attack experience:  In a freakish coincidence, my reader Kathleen had what doctors call a “widow maker” heart attack just eight days before her husband’s heart attack – which was how she learned firsthand the difference between how men and women can be treated.  Despite weirdly similar cardiac symptoms, diagnoses and treatments, for example, Kathleen was told in the hospital that she could return to work the next day, while her hubby was told to take 5-6 weeks off work. (Both had remarkably comparable desk jobs).

4.  Weirdest out-loud comments from cardiologists while misdiagnosing female heart patients:

• “Honey, you have recently moved away for the first time. You are probably just lonely for your mother. I would go and have a baby if I were you!”  (aortic and mitral valves replaced, pacemaker implanted)
• “You’re going to need a new job where you can lay down a lot. How about a mechanic? Or a prostitute?” (Prinzmetal’s Variant Angina)
• “That sharp pain is probably just psychological.” (three stents, Peripheral Artery Disease)

5.  Weirdest way the human body can help to stop a heart attack all by itself:  In about one-third of heart attack patients, the small normally closed blood vessels called collateral arteries can wake up, open wide, and enlarge enough to form a kind of detour stretching around a blocked coronary artery, thus providing an alternative route for blood flow to feed the oxygen-starved heart muscle. Do-it-yourself bypass surgery!

6.  Weirdest typo to confuse an unsuspecting public:  Dr. Colin Baigent is a co-author of a 2002 study looking at whether taking a daily low-dose aspirin helps to prevent a heart attack, published in the British Medical Journal (BMJ). As Dr. Baigent told a HeartWire interviewer: “In the original print edition of the BMJ paper, the final sentence reads: ‘For most healthy individuals, for whom the risk of a vascular event is less than 1% a year, daily aspirin may well be appropriate.”   But here’s the problem: that last word was a typo. An official correction swiftly issued by the BMJ noted that the final word should have been, in fact, “INappropriate”.  It was never the researchers’ intention to say that daily aspirin in low-risk patients was a good idea. Too late!  Despite that correction (and a BMJ apology), taking a daily low-dose aspirin to help prevent a heart attack has become normalized among low-risk adults – even with more recent studies offering NO  evidence that aspirin works for this population, and may in fact be the cause of severe bleeding issues. 

7.  Weirdest cardiology conference findings: Whenever I have attended the Canadian Cardiovascular Congress in Vancouver, it’s been with an accredited press pass so that I can interview researchers presenting papers at this conference about women’s heart disease issues. But at my first CCC event in 2011, I learned that, out of hundreds of cardiology papers being presented at the conference that week, only four studies were about heart disease in women – a stunning reality which then became the Big Story of the entire event, and – weirdly – really helps to explain #8.

8.  Weirdest timing of an official scientific statement from a major heart organization: On January 31, 2016, the American Heart Association released a scientific statement on women’s heart attacks, concluding that, compared to men, women tend to be under-treated during their heart attacks. That’s pretty upsetting news, but I couldn’t decide which part of the statement upset me more:  that particular conclusion (which in 2016 we already knew from many previous studies), or the fact that this was the first ever official scientific statement in the 92-year history of the AHA to focus on women and heart attacks. Yes, you read that right. . .

NINETY-TWO YEARS!

9.  Weirdest mismatch of answers to the same question about what it’s like to live with heart disease:  This Italian study asked three groups of people with an interest in heart failure (heart patients, their family caregivers, and their cardiologists) to describe what it’s like to live with this diagnosis. Over 80% of the patients and families used words like “fear” or “anguish”, yet 70% of the cardiologists used words like “optimistic”.  That is weird. (And by the way, when will cardiologists come up with a new name that’s less hurtful than heart FAILURE?) 

NOTE:  To learn more about why we need doctors to stop telling patients out loud: “You have heart FAILURE!!”, read my British Medical Journal editorial published in BMJ Open Heart (December 2023) called “Heart Failure: It’s Time to Change the F-Word”.

10.  Weirdest research studies containing NO WOMEN:  This turns out to be a long and crazy-weird list, but my personal favourite was the Baltimore Longitudinal Study, which included no women for its first 20 years – because the building in which the study was conducted had only one toilet. .

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Now, back to those AHA national survey results that showed women are LESS aware now than they were a decade ago:  the results confirm what communications experts like Ann Christiano and Annie Neimand at the University of Florida have been warning us about. As they wrote in their report called Stop Raising Awareness Already,  published in the Stanford Social Innovation Review:

    “Because abundant research shows that people who are simply given more information are unlikely to change their beliefs or behavior, it’s time for activists and organizations seeking to drive change in the public interest to move beyond just raising awareness.”

“Unlikely to change beliefs or behavior”?  But isn’t that why we share information, facts and statistics? To correct misinformation out there – like the overwhelming belief that breast cancer is women’s biggest health threat?   WARNING:  scary statistic alert!   It isn’t. Heart disease kills significantly more women each year than all forms of cancer combined.

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NOTE FROM CAROLYN:  I wrote much more about weird facts about cardiac diagnoses in women in my book  “A Woman’s Guide to Living with Heart Disease“.  You can ask for it at bookstores (please support your local independent bookseller!) or order it online (paperback, hardcover or e-book) at Amazon – or order it directly from my publisher Johns Hopkins University Press (use their code HTWN to save 30% off the list price).

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Q: Have you learned some weird facts about heart disease since your own diagnosis?