Heart Disease and Women

Did you know the stethoscope was invented to maintain a woman’s modesty? True. Before the advent of this signature doctor’s instrument, physicians would simply place their ear directly on a patient’s chest. You could see where this could create a problem – especially in a time when to show an ankle was akin to solicitation. Of course, if your doc is George Clooney, bring on the inappropriate closeness. If your doc is Regina Benjamin, 18″ of rubber tubing is a great idea. Even with the help of a stethoscope, for centuries, physicians were hesitant to diagnose heart disease in women. Women got breast cancer, men got heart disease — even in a medical setting, those men couldn’t see past the boobs. When I was in medical school, there was just the beginning of a buzz about the need to recognize heart disease in women. I know I’m getting older but this wasn’t that long ago. Why did it take so long to recognize that heart disease, the #1 killer of women, is, in fact, a killer of women?

1. Women often experience heart disease differently than men. There are typical heart attack symptoms we all know – crushing chest pain, left arm pain, and neck and jaw pain. A woman having a heart attack is likely to have unusual fatigue, nausea, sleep disturbances abdominal discomfort, indigestion, anxiety, shortness of breath and upper back pain.

2. I know. I have you all thinking you are having a heart attack – especially now at the start of the holiday season – GOOD. Another reason women do not get diagnosed with heart disease is we don’t acknowledge our symptoms. Like ovarian cancer, the symptoms of heart disease may be very generic. We go through our lives anxious, exhausted, and bloated – if we addressed every ache and pain we wouldn’t get anything done. Lord knows there are trees to be decorated and presents to be bought – we can’t let a little blocked artery slow us down.

3. Historically, doctors and nurses don’t believe women. All those years of corset-induced fainting spells have hurt our chances of getting a timely diagnosis. Like the boy who cried wolf, the histrionic woman crying heart attack, is often ignored. Unfortunately, so is the calm, composed lady who know something is wrong but simply says she doesn’t feel good.

4. Almost 80% of women who have a heart attack, report having some warning symptoms in the month prior to the event. 70% of women have no chest pain.

5. According to a Vogue (yes, Vogue) article I just read, women in their 30s and 40s are at highest risk of dying from a heart attack. Women, as a gender, have a greater risk of dying instantly from a heart attack and of dying in the subsequent weeks. Women also do worse after cardiac surgery.

More on why women have different symptoms and how to interpret them tomorrow. You may have noticed I found some information in the obscure medical journal, Vogue. In addition to finding out what men really want in bed, you can now find ways to recognize your heart attack — in or out of bed. This is good news to me. While we are still a gender obsessed with our outward appearance, perhaps we are getting more savvy about our inner workings. After all, it’s very tough to look fashionable in a casket.

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