Women Get Short Shrift in Heart Attack Care

More than 15,000 women younger than 55 die of heart disease every year in the U.S., and younger women are twice as likely to die after being hospitalized for a heart attack as are men of the same age.

So why do women typically wait much longer than men to seek emergency care for a heart attack, and why, once they’re at the ER, are their symptoms so often misdiagnosed?

That scenario was the subject of a recent report on NPR. It referred to a study published in Circulation: Cardiovascular Quality and Outcomes that interviewed 30 women ages 30 to 55 who had been hospitalized after a heart attack.

Remarkably, many of them didn’t know what a heart attack feels like.

The study’s lead author, Dr. Judith Lichtman, an epidemiologist at the Yale School of Public Health, commented to NPR, “We often see it portrayed as someone falling to their knees, holding on to their chest. Maybe we need to do a better job of explaining and describing to the public what a heart attack looks and feels like.”

In fact, for women, a heart attack involves not only some chest pain, but usually a host of other other symptoms, including neck pain, jaw pain, indigestion, fatigue and nausea.

Even when women suspect that they might be having a heart attack, many are reluctant to express that they might be having a cardiac problem. They’re concerned, Lichtman found, that they might be wrong, that they might be over-dramatizing things.

Making the situation worse is that doctors often reinforce these fears by assuming that they are suffering from indigestion, or maybe a panic attack, rather than a heart attack.

“So I think it is really critical that we empower women to not feel any stigma or judgment,” Lichtman told NPR. She also said that recognizing what’s really happening requires doctors to be better listeners, and when have we heard that before? (See our blog, “When Doctors Don’t Listen, Patients Don’t Thrive.”)

Practitioners also need to pay special attention to women who have high blood pressure or cholesterol, or a family history of heart disease.

The American Heart Association spells out the signs of heart attack in women:

  • uncomfortable pressure, squeezing, fullness or pain in the center of the chest that lasts more than a few minutes, or goes away and comes back;
  • pain or discomfort in one or both arms, the back, neck, jaw or stomach;
  • shortness of breath with or without chest discomfort;
  • breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

If you experience any of these signs, summon help within five minutes. If you must, call 911 and get to a hospital right away.

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