RECOGNIZING THE SIGNS

Women are less likely to seek help after experiencing symptoms, studies show.
By TRACEY D'ASTOLFO
VINDICATOR CORRESPONDENT
A man suddenly clutches his chest, gasping for air, and falls to the ground.
An ambulance rushes him to the hospital, where he is told he has suffered a heart attack.
Most people have witnessed this scene on television or in the movies, but many don't know that women's heart attacks are not always so easy to spot and their symptoms are often subtler than those of the classic "movie heart attack."
Although chest pain is a common symptom for heart attacks in women, there are other atypical signs that are more common in women than men. The American Heart Association reports that these symptoms may include shortness of breath, pain in the back, neck, jaw or arm, fatigue, nausea and breaking out in a cold sweat.
Dr. Joseph A. Graziano, a cardiologist at the Heart Center of Northeastern Ohio and president-elect of the Youngstown branch of the American Heart Association, said many people believe they will clearly know if they are having a heart attack and will experience chest pains.
"This always amazes me but, out of a hundred heart attacks, probably 20 percent of them come in clearly having chest pains," he said. "People most often will describe it as pressure, heaviness, discomfort and, particularly in women, back discomfort, neck discomfort, shortness of breath and sweating."
Heeding symptoms
Graziano said a good predictor of a heart attack that all people should heed is when something feels out of the ordinary for them.
"Some people get winded and short of breath walking to their mailbox, but other people can jog a mile and feel pretty good," he said. "The best [indicator] I can suggest is when something feels distinctly different for that individual."
Lily M. Wagner of Youngstown, who underwent triple bypass surgery after a major blockage was discovered in her arteries, said she called her doctor the day after feeling mild discomfort in her chest and left shoulder in 2003.
"It was a good thing I went when I felt the pain. It could have become a heart attack at some time if I had totally ignored [the symptoms]," she said.
Studies show that women are less likely to seek care when they experience symptoms of heart problems, possibly because they are often unaware of the sometimes subtle signs of heart disease and heart attack.
Misdiagnosis
Physicians may also misdiagnose heart disease in women, partly because their symptoms are different than men's and partly because the routine diagnostic tool -- the treadmill test -- is not always a reliable test for women. Studies funded by the National Institutes of Health have shown that the treadmill stress test gives false results in up to 40 percent of women.
The National Heart, Lung and Blood Institute reports that women are less likely to recover after a heart attack, possibly because of failure to identify early signs of heart disease and heart attack in women.
An NHLBI study found that some women experience undiagnosed warning signs up to two years before having a heart attack, with the five most-frequent symptoms being fatigue, sleep disturbance, shortness of breath, indigestion and anxiety.
A 2000 AHA survey found that only 9 percent of women know that nausea is a symptom, and 5 percent know that fatigue is a symptom, two very common heart attack signals in women. Studies show that fast action is the best way to survive a heart attack and that clot-busting drugs or other life-saving procedures are more effective when administered within one hour of the start of heart attack symptoms.
Delaying
Women tend to wait two or more hours after their symptoms begin before seeking medical help, studies show. This delay can result in death or permanent heart damage. Studies also show that women are less likely than men to believe they are having a heart attack and more likely to delay seeking emergency treatment.
The AHA urges anyone who suspects they are having a heart attack to call 911 immediately, and not to attempt to drive themselves to the hospital. Emergency medical personnel can begin treatment immediately and have the equipment to start the heart beating again in the event of cardiac arrest on the way to the hospital.
Wagner said she is lucky she heeded the message her body was sending, and encourages other women to pay attention to their own bodies.
"Listen to your body if you feel something is wrong. The pain doesn't have to be severe enough to knock you down. My pain was very mild. Listen to the changes in your body," said Wagner.