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Women and Heart Health

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How to save your life through education and empowerment

Actress Carrie Fisher became a modern legend as the feisty Princess Leia in the Star Wars movies, creating an “I-can-do-anything” role model for young girls. Hopefully her shocking death at the age of 60 due to a cardiac incident while quietly sleeping on a plane will influence women to be more mindful of the importance of maintaining a healthy heart and heeding the symptoms that signal when something might be wrong.

“The most common way women present with heart disease is dead, dead on arrival,” says Dr. Kathy Magliato, a cardiothoracic surgeon at Saint John’s Health Center in Los Angeles during a recent ABC News interview. “Women tend to downplay their symptoms and they tend to wait longer to come to the hospital and that’s why they die at home.”

Cardiac vascular disease is the number one killer of women in the United States, responsible for about 400,000 deaths per year. That’s about one death per minute, according to the American Heart Association.

“We have to think of this disease as a woman’s disease, it’s not a man’s disease,” Magliato says. “The symptoms between men and women are so drastically different that what women believe is heart disease is really men’s heart disease.”

When most people think of a cardiac episode they often picture this stereotypical scene: 
a man walks down the street, suddenly clutches his chest, doubles over in pain and collapses to the ground. Most of the time, however, women have symptoms unrelated to chest pain, which are much subtle.

Gainesville resident Ingmarie Peck knows this all too well. “I had some weird pains in my right arm,” she says. “They were very painful and came and went so I didn’t think too much about it.” So, she continued with her daily life of work, exercise and family. Then one day she started to feel dizzy and actually passed out. “It happened at home and my daughter happened to be there. She called 911, but they couldn’t find anything wrong,” she says. “So I went on with my merry life the way I used to.”

The symptoms persisted, eventually creating a life-threatening situation. She was driving home from work and was just beyond the Oaks Mall when she passed out and drifted down the road. Peck was taken immediately to the hospital and evaluated. Physicians found a blockage and placed a stent to correct it. That was in 2002, at the age of 52. Now, at 66, Peck still has the stent and is symptom free.

“It just crept up on me,” Peck says. “You know, I never correlated the pain with something that could actually be wrong with my heart. It was the wrong kind of pain. I mean the right arm? That was weird. It was more like in my wrist and elbow.” The human body is comprised of intricate systems that are adept at giving signals when something is going wrong. The challenge is interpreting them.

“The press tends to cover the atypical cardiac events that can happen, especially in women and they do happen,” says Steven Yucht, M.D. with Emergency Physicians Medical Center of Gainesville. “But the most common symptom of a heart issue is chest pain. “The challenge is that everybody
has a different perception of chest pain,” Yucht says. “A little bit of pressure in one person may be a huge deal in another. It is subjective. If you are having crushing chest pain, that‘s easy.”

What can be confusing, however, is when the pain manifests in another part of the body aside from the chest, which happens frequently in women. Nerves can be affected creating discomfort that can manifest in the jaw or – instead of the traditional left arm – experiencing pain in the right arm, as in Peck’s case.

Why these atypical symptoms occur in females isn’t well documented, but what research has shown that women’s cardiac disease tends to develop in small micro vessels that supply blood to the heart. Charles Klodell, M.D., cardiothoracic surgeon with the Florida Heath and Lung Institute agrees.

“From an anatomic standpoint, women are often smaller in stature and have smaller- sized coronary arteries, leading to more significant disease at similar levels of
 disease burden, he says. Klodell says the most common symptoms of CVD in women are the typical shortness of breath, chest heaviness, fatigue, nausea, vomiting and tiredness with exertion, but there is a big difference. “Many times women can present in an identical fashion, although presentations can be atypical in women. Women are more often thought to have non- cardiac related chest pain
and often their symptoms
are trivialized,” he says.

Wherever the feeling
 of discomfort may be,
 both physicians urge 
that action be taken.
“You should get any 
chest pain checked out
 at an acute care center 
or the emergency room,”
Yucht says. “Don’t wait to see
your doctor in a week and don’t do rationalizing like it’s no big deal.” Especially new pain that is unfamiliar to you. “Number one, if it is something you have never had before, you should probably get it checked out. You are going to get value in getting it checked out, especially if it turns out that there is something wrong,” Yucht says. “Especially nagging discomfort that’s been being on for a day or more.”

Klodell agrees. “It is imperative that a cardiac etiology for all chest pain be the initial assumption and remains the assumption
 until proven otherwise. Perhaps the best tactic, however, is to prevent developing heart disease in the first place. The American Heart Association (AHA) has lead efforts in research, prevention and treatment of heart disease, providing knowledge-based solutions for people of all ages.

The good news: increasing your heart health is in your control. “Making changes to your lifestyle, like eating healthier and exercising more, can reduce the risk of heart disease by as much as 80 percent,” says Jimmy Clarity who is the current Communications Director for the American Heart Association, Greater Southeast Affiliate.

Of course, the type of food consumed plays a critical role in the development and in the prevention of heart disease. A diet low in saturated fats, with plenty of fresh fruit and vegetables can reduce the risk of developing heart disease more than 70%. To help make choosing heart healthy foods easier, the AHA created a program called, Life’s Simple 7. “This is an easy-to-embrace way to significantly lower the risk of heart disease and improve our health,” Clarity says. The seven areas to focus on collectively help prevent CDV and stroke. The AHA program focuses on blood pressure, cholesterol, physical activity, healthy diet, weight and the importance of not smoking.

Modifying and changing lifestyles can reap major health benefits, but isn’t always easy. A sedentary lifestyle starts early, according to AHA statistics. The physical activity level in girls, for example, declines starting at the age of thirteen. This decline is probably why weight issues happen at a young age.

The AHA estimates that 30 percent of girls ages two to 19 are overweight or obese, and almost 64 percent of the women 20 years of age and older are as well. Almost 80 percent of both African-American and Mexican- American women are overweight or obese.

Again, the AHA is trying to make change as easy as possible. An easy and delicious way to improve heart health is to learn to cook healthy meals at home. “Our recipe website, recipes.heart.org, has a ton of great ideas and even a budget-friendly category. It’s easier than most people think to eat healthy,” Clarity says. “Yet sometimes,” he says, “you can follow all of these suggestions and it isn’t enough [to prevent heart disease] due to a person’s genetic make-up and heritage.”

“I have always been a very physical person,” Peck says. “I was running 5Ks until a foot problem developed. I am on medication for high blood pressure and high cholesterol.

I go to the doctor once a year.” Peck went onto say that her overall apparent health
 was why she didn’t take a more aggressive approach when she experienced excruciating pain in her right elbow and wrist. “I should probably have gone to the doctor and complained about the pain,” she says, “but a heart problem was so far from my mind.”

Klodell says a lack of action to seek 
answers is not uncommon. “From a societal standpoint, women are often less likely to seek medical attention, or their symptoms are misdiagnosed as other problems,” he says. “This is a societal stereotype that we must all work to assiduously ameliorate.”