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What You (and Your Doctor) Don't Know Can Kill You


That would probably be news to many women. Giardina cited a 1997 poll by the National Heart, Lung and Blood Institute that found 61% of women polled said cancer posed the greatest threat to their health, versus just 7% who said the same thing about heart disease. Giardina is professor of clinical medicine and director of the Center for Women's Health at Columbia University College of Physicians and Surgeons in New York.

The typical heart attack victim has long been thought of as a white man over 60 or a very elderly woman, Loving says. And many physicians aren't trained to look for heart disease in women or to recommend strategies to guard against it.

The reason for this is that heart disease hasn't been studied much in women. Nearly all the early studies of heart disease excluded women, Sharonne Hayes, MD, tells WebMD. It was thought that the heart-friendly action of estrogen kept women immune to heart disease until well after menopause. So a woman under 50 who has heart attack symptoms may be told she's too young to have a heart attack and misdiagnosed with flu -- or something as bizarre as shingles. Hayes is a cardiologist at the Mayo Clinic in Rochester, Minn., and assistant professor of medicine at the Mayo Medical School.

Another reason physicians often miss women's heart-attack symptoms is that they do not usually manifest as the crushing chest pains that men experience. The symptoms women heart-attack victims tend to suffer can also be caused by a variety of other disorders.

According to Womenheart, the symptoms of heart attack in women can be any of the following:

  • Discomfort, fullness, tightness, squeezing, or pressure in the center of the chest that either comes and goes or stays for more than a few minutes
  • Pressure or pain in the upper back, shoulders, neck, or arms
  • Dizziness or nausea
  • Clammy sweats, heart flutters, or paleness
  • An unexplained feeling of anxiety, fatigue, or weakness
  • Stomach or abdominal pain
  • Shortness of breath and difficulty breathing

When Loving was diagnosed with her heart attack, she learned that her cholesterol reading was 313. She hadn't been tested in 10 years, despite her known health risks. "The collective ignorance is appalling," Loving says.

The major risk factors for heart disease in women are:

  • Being over 55 and postmenopausal
  • Having a family history of the disease
  • Smoking
  • Having a cholesterol level over 240 or blood pressure more than 140/90
  • Leading a sedentary lifestyle
  • Being more than 20 pounds overweight
  • Having diabetes
  • Being African American. Not only do black women have a higher incidence of heart disease than white women, they are twice as likely to die from the disease.

While younger women are not as prone to the disease as their counterparts over 65, heart disease still claims 9,000 U.S. woman under 45 each year, and a total of 74,000 under 65.

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