For women, heart attacks look different – and so do heart health outcomes

Heart disease is the number one killer of women in America. Approximately 26% of women who die in this country every year die of heart disease – that’s about 316, 000 women a year. And, a new study reveals that women who have heart attacks are more likely (15%) to die in the hospital than men who have heart attacks (10%).

There are a number of reasons for this. As USA Today reported yesterday, “women are less likely to get immediate treatment to stop the heart attack in its tracks: clot-busting drugs, balloon procedures to open the arteries or bypass surgery.” This delay accounts, in part, for the five percent disparity in in-hospital death rates.

The study also found that women often fail to realize that they are having a heart attack – and so do doctors. This is because heart attack symptoms in women can be different than they are in men. The symptoms we most commonly associate with a heart attack, like pain in the left arm and tightness in the chest, don’t always occur in women. The study found that 42% of women who have heart attacks never experience the “classic heart attack symptom” of tightness or pain in the chest. Instead, they may develop pain in the back or jaw, light-headedness, nausea, vomiting and shortness of breath.

Heart attacks kill people of both sexes, but they affect female bodies differently than they affect male ones. The problem with having “male” as the default in medical research, and even in public health awareness campaigns, is that it fails to account for these differences, often with serious or even fatal consequences. The common heart attack symptoms for female bodies are ones we often associate with panic attacks or anxiety, especially when they appear in women.

That is exactly what happened to my mother. When I was a teenager, mom had a heart attack. She was fifty-one. She was driving when the symptoms happened, but luckily, she wasn’t alone. My sister, who had just gotten her learner’s permit, was in the car, and they happened to be just a few minutes’ drive from an emergency room. Mom told my sister that something was wrong and that she needed to go to the hospital, so my sister jumped behind the wheel and drove to the hospital.Once she got to the ER, Mom told doctors that she thought she was having a heart attack. They were fairly certain she was having a panic attack. Mom insisted that it was her heart, and she was right. She was treated for a heart attack, and though it took her a while to recover, her recovery was full; she is alive, and well, and there was no permanent damage done to her heart.

The reason she recovered fully is because she got the right treatment, and she got it fast. Heart health experts call the one hour window after symptoms of heart attack start “the golden hour,” in which it is essential to begin treatment.

As this study suggests, women are less likely to get treatment in that golden hour, partly because their symptoms manifest differently than men’s, and partly because despite the numbers on women and heart disease, when we think heart attacks, we think men. This misconceptions affects both patients and doctors, and it creates real disparities in healthcare – and in mortality rates.

February is American Heart Month, and 2012 marks the tenth anniversary of The Heart Truth, a heart disease awareness campaign targeted specifically at women. If you’ve never considered the possibility that you might be at risk for heart disease, take a moment to read up on it today.

And if you find yourself lightheaded, nauseous, short of breath, or with sudden back pain, don’t downplay it. Take a play out of my mom’s book, and the advice of Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital: “If you think you’re having a heart attack, say it. And if you’re wrong, then you’re wrong.” But if you’re right, you’ve got a much higher chance of getting treatment and making a full recovery.

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3 Comments

  1. Posted February 23, 2012 at 2:41 pm | Permalink

    Dr. Gabor Mate has some interesting things to say about the differences we see among populations in heart disease and other diseases, and why it is that in the US, African American men have a higher risk of heart disease than their “genetic relatives” on the African continent. He has a body/mind/spirit kind of approach to health… He can be heard on a Democracy Now broadcast here: http://www.democracynow.org/2010/12/24/dr_gabor_mat_on_the_stress

  2. Posted March 6, 2012 at 4:30 am | Permalink

    Same thing happened to my mother last fall: she had a couple of days where she was very tired and a little nauseous, until one afternoon she came home from a walk and that was it, she said she was having an heart attack. She showed none of the symptoms we normal, non-trained, non-doctors people look for when we hear the words heart attack and she was relatively fine, so the absurdity of the moment led me to downplay it and treat it like a panic attack (a thing she was no stranger to), and I have much much regret for what I said in those firsts moments, but she knew it and she was so scared that we went to the ER. And she was damn right.
    I can’t say we were REALLY prompt, nor that the hospital was a nice and easy ride, but her episode was over by the time we arrived.
    But there they said that was just the beginning: due to the origin of her problem, the coronaries being obstructed, if we didn’t went in that day, in the next ones a bigger and possibly fatal heart attack would’ve occurred, and who knows what I would be writing right now.
    From that day she underwent a couple of procedures that took their tool on her and she is just now finding her good spirit again, but she is physically sane and I didn’t lost my mom because in tv they won’t show a woman having an heart attack.
    DO NOT UNDERESTIMATE THOSE FIRST SYMPTOMES. Better be safe than sorry, trust me.

  3. Posted March 7, 2012 at 7:24 pm | Permalink

    I hate the idea that women are dying from sheer misinformation, so I’m glad this article is spreading the word. Do you know if there’s information on symptoms in trans people, as well?

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