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Women & Heart Disease

Back or neck pain, fatigue, and an upset stomach could be the flu.

Or, it could signify a heart attack.

Shortness of breath, sweating, and lightheadedness could be anxiety or menopause.

Or, it could signify a heart attack.

For women, a heart attack doesn’t always come with the obvious sign of crushing chest pain. Symptoms can be more subtle than that. Because the heart attack symptoms for women are sometimes less obvious than for men, they are often dismissed as such things as hot flashes, muscle aches, stress, or feeling under the weather, causing women to delay seeking help for this medical emergency.

Delaying life-saving treatment contributes to this statistic from the American Heart Association (AHA): women are 15 percent more likely than men to die of a heart attack. Heart disease, which includes heart attack, is the leading cause of death for women (and for men) in the United States, more than all forms of cancer combined. Yet, according to the AHA, women still feel more threatened by cancer than they do by heart disease.

Heart disease and heart attack are pervasive and deadly—yet underestimated—threats. So increasing awareness is crucial. February is designated as American Heart Month to do just that, because better understanding, combined with pursuing healthier and more active lifestyles, helps save lives.

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Heart Disease Definition
Heart Attack Signs
Risk Factors
Lowering Risk
For More Information

Heart Disease Definition
So what is heart disease? It’s a term that describes conditions affecting the heart or blood vessels. The most common cause of heart disease is atherosclerosis, which is the narrowing or blockage of the blood vessels due to plaque buildup. The obstruction of oxygen-rich blood to the heart can cause a heart attack; similarly, lack of blood to the brain can cause a stroke. Both are life-threatening medical emergencies.

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Heart Attack Signs
“As with men, the most common heart attack symptom in women is chest pain or pressure,” says Dr. George Waters, board certified Cardiologist. “But women must pay attention to other common symptoms.” These include:

Pain or discomfort in the arm(s), back, neck, shoulder, or jaw. This pain can occur during a heart attack because the nerves that supply these areas also supply the heart.

Shortness of breath. Getting winded while you’re not exerting yourself is a sign of a heart attack. This can happen because a heart attack can decrease the pumping function of the heart, while increasing blood pressure in the heart and lungs.

Sweating and rapid heartbeat. While these symptoms can be confused with stress or anxiety, breaking out in a nervous, cold sweat while at rest or engaging in a mild or gentle activity could be your nerves reacting to your heart’s overexertion.

Lightheadedness, dizziness, or fainting. During a heart attack, the heart cannot pump blood adequately, causing a serious lack of blood supply to the brain and therefore, symptoms like lightheadedness.

Unusual fatigue and weakness. Fatigue can be caused by decreased blood flow to the brain and other organs.

Indigestion, nausea, or vomiting. Similar nerves supply the stomach and the heart, so when areas of the heart are injured, this can cause upper gastrointestinal symptoms.

Sleep disturbance. Trouble falling asleep or staying asleep, even weeks before a heart attack occurs, can also be heart attack symptoms.

“Recognizing and treating these symptoms as early as possible saves heart muscle from oxygen deprivation and prevents heart damage, which saves lives,” says Dr. Brian Kelly, FACEP, Chief of Emergency and Occupational Services.

When experiencing these symptoms, call 911 to get immediate medical attention. “Rather than having someone drive or take you to an emergency room,” says Dr. Kelly, “calling 911 is safer, as it quickens response and enables treatment to initiate sooner. Paramedics can obtain an EKG prior to transport to confirm the heart attack, and bring the patient directly to a medical facility that can perform life-saving cardiac catheterization. Determining the appropriate destination of the ambulance at the start, saves time.” Paramedics can also start IV lines, give oxygen, nitroglycerine, aspirin, and other treatments as well as notify the hospital that they are bringing in a heart attack patient, so staff can further prepare. “Time is everything when it comes to responding to a heart attack, so it’s vital to seek, and begin, treatment right away.”

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Risk Factors
But what about preventing heart disease and heart attack in the first place? According to Dr. Waters, “Factors like being overweight, inactivity, smoking, high stress, and family history increase the risk of heart disease and heart attack.” While some factors, like genetics, aren’t modifiable or controllable, an important step to protecting yourself against heart disease is knowing your risks and gauging your health status:

Poor diet and excess weight. A diet that's high in saturated fat, salt, and cholesterol can contribute to the development of heart disease, as well as being overweight or obese.

High cholesterol. High blood cholesterol levels, whether from lifestyle factors or genetics, can cause plaque buildup in the arteries.

High blood pressure. Uncontrolled high blood pressure can result in hardening and thickening of the arteries, narrowing the blood vessels.

Physical inactivity. Lack of exercise and sedentary lifestyles can increase the risk of high blood pressure, high cholesterol, blood clots, and heart disease.

Age. Simply getting older increases the risk of damaged and narrowed arteries and weakened heart muscle. About 82 percent of people who die of heart disease are 65 or older, according to the AHA.

Family history. A family history of heart disease increases your risk of heart disease, especially if a parent or sibling developed it at an early age.

Race. According to the AHA, heart disease risk is higher among African Americans, Mexican Americans, American Indians, native Hawaiians, and some Asian Americans. This is partly due to higher rates of high blood pressure, obesity, and diabetes.

Smoking. Heart attacks are more common in smokers than in nonsmokers for a number of reasons. The likelihood of atherosclerosis increases because nicotine constricts blood vessels, and carbon monoxide can damage their inner lining. Smoking can also cause the platelets in the blood to clump together and form clots.

Diabetes. High blood glucose (sugar) levels from diabetes can, over time, lead to increased deposits of fatty materials on the insides of blood vessel walls, which may affect blood flow.

High stress. Chronic or unrelieved stress may damage arteries as well as worsen other heart disease risk factors like overeating, high blood pressure, etc.

Poor hygiene. Failure to establish good hygiene habits (e.g. regular hand washing) increases exposure to viral and bacterial infections, and therefore raises the risk of heart infections. Poor dental health can also contribute to heart disease.

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Lowering Risk
Knowing the heart attack symptoms and identifying your heart disease risk are measures you can take to prevent heart disease and heart attack. Also important is making healthy lifestyle changes. Dr. Waters recommends “eating a healthy, low-cholesterol diet, exercising regularly, quitting smoking, and seeing your doctor on a regular basis.”

According to Sue Nordstrom, BSN, RN, Cardiac Rehabilitation Coordinator, “Healthy lifestyle modifications lower the risk for heart disease in the first place, and for those who are diagnosed, healthy changes can significantly reduce the risk for future heart problems.”

Regarding nutrition, focus on eating fruits, vegetables, fish, fiber-rich whole grains, nuts, legumes, and seeds, and limit consumption of sodium, sugar-sweetened beverages, processed meats, and saturated fats.

“To increase physical activity,” says Nordstrom, “start with a small goal, such as walking five to 10 minutes. Commit to it regularly and it will be easier to gradually exercise longer and more vigorously. Aerobic exercise for as little as 30 minutes a day as well as strength and stretching exercises can improve heart health as well as overall stamina, flexibility, and energy.”

As for smoking, if you don’t smoke, don’t start. And if you do, quit, as quitting smoking reduces your risk for heart attack each year that you remain a nonsmoker.

Keeping an eye on your health status is also important. Scheduling and keeping annual exam appointments with your primary care physician will monitor your health status with regard to blood pressure, cholesterol, heart rate, blood glucose, and weight. Changes that set off red flags can prompt further screening and follow-up care. If you’ve already been diagnosed with a cardiovascular condition, your physician will probably require that you have additional and more frequent testing.

For More Information
When work life, family life, and personal life get busy, prioritizing your health can often fall by the wayside. But heart health is essential. For more information about women and heart disease, visit the American Heart Association’s “Go Red For Women” campaign website at

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