Better Health & Living: Article: Get The Facts About A Woman's Heart

Issue: February 2008

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Get The Facts About A Woman’s Heart

by Susan Flagg Godbey

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Cardiology nurse Evan McCabe was just 47 when she felt chest pain and tingling down her left arm after a walk with a colleague at Santa Barbara City College, where she’s an associate professor of nursing. “I said I was fine,” recalls McCabe, now 51. “Inside, I was thinking ‘This can’t be happening to me!’ ”

A battery of tests revealed that McCabe had heart disease. Her cardiologist prescribed cardiac rehab (an exercise and healthy lifestyle program) and medications. Now, McCabe’s doing more: She’s bringing an urgent message about heart disease awareness to women, often in small living room gatherings. “Most women think breast cancer is their biggest health threat. Just 13 percent of women know the truth: Heart disease is the biggest killer of women in America today,” she says. “About 435,000 women have heart attacks each year—and many are under age 65.”

Here, McCabe answers your questions about heart disease in women.

Q: Can women really have a heart attack without feeling any chest pain at all?

A: Yes! Researchers have found that many women experience dizziness; nausea; shortness of breath; and/or cold, clammy sweating at the start of a heart attack. Other “nontraditional” signs include abdominal, shoulder, or jaw pain. And when women do have chest pain, some have classic, crushing pain, while others experience tightness or aching or pressure high in the chest or even the back. If you’re feeling any of these, call 911.

Q: I’ve had symptoms of fatigue and indigestion (unusual for me) in the past few months. I have a family history of heart disease. Should I be concerned?

A: From current research, we now know those could be two subtle signs of an impending heart attack. In one study, 95 percent of women had new or unusual warning signs, including unusual fatigue, shortness of breath, anxiety, and indigestion, during the month before their heart attacks. Those seemingly benign symptoms are easy to explain away, but don’t. If you don’t feel right—you’re suddenly exhausted, for example, or have extreme heartburn, and there’s no discernible reason for it—see your doctor immediately or go to the emergency room.

Q: I don’t have a family history of heart disease, and my doctor’s never said anything to me about it. Does that mean I’m okay?

A: You need more information about your cardiovascular health, specifically your cholesterol and triglyceride levels, blood pressure, and blood sugar levels.
The American Heart Association says it’s good to have a total cholesterol reading under 200 mg/dL. Women also should aim for “good” HDL cholesterol of 50 or higher and “bad” LDL cholesterol under 100 if possible (or between 100 and 129). Shoot for triglyceride levels under 150 mg/dL and blood pressure readings of 120/80 or lower.

You and your doctor should also check for signs of metabolic syndrome, a prediabetic condition that raises your risk of heart disease and diabetes. You’re at risk if you have any three of these: a waist measurement of 35 inches or more, high triglycerides, low HDL cholesterol, blood pressure of 130/85 or higher, or a fasting blood sugar test result of 100 mg/dL or higher.

Q: My doctor has dismissed me when I’ve asked about symptoms, saying they’re just stress related. Now what?

A: Be ready to advocate for yourself with your healthcare provider. Remember that you’re the client in this relationship and can ask for what you need. The key to avoiding a heart attack is an accurate diagnosis of heart disease and then proper treatment. Statistically, women are not given cholesterol-lowering drugs as frequently as men are, and they don’t get as many stents or bypass surgeries as men if tests show a blockage in a coronary artery. Educate yourself so you know what to ask about. That means reading up on heart disease at high-quality Web sites like the American Heart Association (www.americanheart.org); the National Heart, Lung, and Blood Institute (www.nhlbi.nih.gov); and WomenHeart: The National Coalition for Women with Heart Disease (www.womenheart.org).

Q: I’ve read that red wine is good for your heart, but I don’t drink alcohol. Should I start?

A: While the American Heart Association doesn’t recommend wine for heart health, my cardiologist, noted women’s heart disease researcher C. Noel Bairey Merz, MD, of Cedars-Sinai Medical Center in Los Angeles, says research suggests that moderate consumption—that’s one 5-ounce glass of wine a day, with a meal, for women—may be beneficial. But ask your doctor first. There are many reasons women should avoid alcohol altogether, such as a family or personal history of alcoholism or a raised risk of breast cancer. Some research suggests that you may get some of the same benefits from a serving of 100% Concord grape juice.

By Susan Flagg Godbey and the editors of Better Health & LIVING®