March 2000

 

Was That a Heart Attack?
Kathy Dothage, dothagem@missouri.edu

It’s no secret that women with coronary artery disease are not treated the same way that men are. Study after study has shown angina and even heart attacks in women may be overlooked simply because their symptoms are not identical to the symptoms experienced by men. The result of this is that women often do not get appropriate diagnostic tests—or even timely treatment.

According to an article in the July/August issue of the Journal of women’s Health & Gender-based Medicine, it appears that doctors are not the only ones who have difficulty in determining when women are actually having a heart attack. The women in question also have problems with making this determination. According to the article, researcher Linda A. LaCharity, documented the experiences of 12 pre-menopausal women between the ages of 31-47, who had suffered disabling heart attacks. Most of them ignored the early signs of heart attack because they weren’t having the classic (male model) symptoms—even though they had the following:

• Risk Factors: All 12 of them had several classic coronary risk factors, including strong family histories of heart disease. One half of them had close relatives who had problems before age 50. Six of them smoked or had hypertension, six were overweight, five had high cholesterol, three had sedentary lifestyles, and two were diabetic. Most knew they were at high risk, but didn’t expect problems until after menopause.
  
• Symptoms: Most of them had nausea and vomiting as the first symptoms, but attributed it to indigestion, the flu, and/or work stress. Several initially treated themselves with non-prescription medicines such as analgesics or antacids, even thought they had chest pains.
  
• Recognition: all twelve eventually realized something was seriously wrong. One took a shower and washed her hair before calling her parents to take her to a hospital. Those who called 911 or went to an Emergency Room were questions by medical personnel and told that they were too young to be having a heart attack.
  
• Outcome: One of the twelve died. Two others had to be resuscitated at the hospital. Eight of the 11 survivors eventually returned to work, but most of them reported exhaustion, difficulty with household chores, and diminished sex lives. Only two of them were sad or depressed, and eight took part in cardiac rehabilitation programs.

The message from these women’s experiences is clear: nausea and vomiting—certainly if accompanied by pain or pressure in the chest, arm, or neck—can signal a heart attack, regardless of age, in women at risk for heart disease.

Source: Harvard Women’s Health Watch, Vol. VII, No. 3, November 1999, pg. 7.

 

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