I got an e-mail from my sister the other day, a chain letter of sorts, where a woman described symptoms she experienced during her heart attack. While I knew that women's heart attack symptoms were often somewhat atypical, I wondered what medical studies said on the topic. I was surprised by just how different the symptoms can be.
A 2003 study looked at more than 500 women who had just experienced an acute myocardial infarction (heart attack). The researchers asked the women to describe their symptoms. They looked both at the acute symptoms during the heart attack, and also at symptoms that may have been clues to the impending cardiac disaster.
Picture a stereotype of a man having a heart attack -- a rotund, smoking businessman, suddenly clutching his chest in pain. While many heart attacks in men are different from this scenario, many still fit that mold. Women, it turns out, tend to do things very differently. This study found that almost half of women experienced no chest pain at all during their heart attack.
If many women have no chest pain during a heart attack, what symptoms do they have? Shortness of breath, weakness and fatigue occur in most women having a heart attack. If there is pain, pressure, or discomfort, it may occur in the chest, but also may appear in the upper back, the jaw, the shoulders, or arms. Many women also experience indigestion, nausea and dizziness. These symptoms are non-specific and may not immediately seem heart-related. Recognizing these signs and getting immediate medical help can be critical to timely treatment for a heart attack.
More surprising to me than the acute symptoms in women, was the apparent existence of a "prodrome" of the female heart attack. This is a cluster of symptoms that may occur a month or more before the actual heart attack, signaling its looming presence. These symptoms may include unusual fatigue, sleep disturbance, and shortness of breath. Only a third of women experience chest pains in this prodromal phase.
What risk factors are associated with having a heart attack? In this study, family history of heart attacks was present in 96 percent of women suffering an MI. This is a risk factor that you cannot change. Risk factors that you can change include lack of exercise, being overweight, high blood pressure, high cholesterol and smoking.
The bottom line is that if you have a family history of heart disease, it may be lifesaving to know the symptoms of a heart attack. If you are female, then these symptoms may be subtle. Talk to your doctor about ways to reduce your risk of a heart attack -- still the No. 1 killer of women.
Dr. Christopher Bartlett is a Portland-based family practitioner. Contact him at:
doc@mydoctorchris.com
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