Dear Dr. Christina,
I am so distraught. I took my wife Amy, who is only 40 years old, to the hospital over the weekend when she was complaining of extreme fatigue, nausea, vomiting, dizziness, indigestion, and nervousness. The doctor told my wife she had a virus and that she probably ate something that did not agree with her. He gave her what he called a "GI cocktail” to help with her indigestion and told her that it would help settle her upset stomach. He told her to drink plenty of fluids, get some rest, and gave her a shot to help calm her nerves. He sent her home with instructions to be seen by her private doctor on Monday.
Two hours later, she threw up and fainted. I called 911 and she died in the ambulance on the way back to the hospital. I was told she had a massive heart attack.
What happened? I thought she only had indigestion, felt tired, and was only having a panic attack. That is what the doctor said and I believed him. Now she is dead.
I feel so betrayed, lost, and guilty. Could I have done something different?
I am so sorry for your tragic loss. No, you did not do anything wrong. Heart attacks are generally more severe in women than in men, and many women unfortunately experience sudden death. Believe me, the number one reason why greater than 1 in 3 women dying is due to unexpected cardiac disease and stroke is the failure to recognize and respond appropriately.
Many of the traditional symptoms of heart attack are based on studies performed on middle-aged white males, and unfortunately not on women or any other ethnic groups.
Here are the traditional symptoms of a heart attack:
- Pressure, fullness, or pain in the chest
- Chest pain that moves to the arm, neck, jaw, or back
- Lightheaded feeling, nausea, or sweating
- Shortness of breath
- Anxiety or weakness
Unfortunately signs of a heart attack in women may not be specific:
- Unusual fatigue
- Sleep disturbance
- Shortness of breath lasting 5- 10 minutes
- A lot of times symptoms are thought of as “it’s just stress” or that it’s just part of getting older
- No chest pain but more of an achiness or maybe tightness in the chest
- Atypical pain such as a hot or burning sensation or back/shoulder/arm are tender to the touch
- No chest discomfort
- Feeling of doom
- Loss of consciousness
- Flu-like symptoms
- Breast pain
- Asthma attack
It is the sudden changes in these symptoms that persist for 5 to 10 minutes that we need to pay close attention to, for they may be warning signs to go see your doctor. Even though these cardiac symptoms may be vague, women have to pay attention to their bodies for it may save your life. Listen to your body and follow your instincts.
Sometimes your doctor may write these feelings or sensations off as a GI, musculoskeletal or panic disorder. It doesn’t matter. Tell your doctor there is something really wrong and that you want a work up. If he or she doesn’t do it, find a doctor who will listen to you.
Many women are likely to have what we call a “Silent MI”, which is a heart attack without any symptoms. The more atypical the symptoms are, the more women delay getting any sort of treatment—and the more likely they are to die.
There is what is called “The Golden Hour of a Heart Attack”, which refers to that first critical hour of getting to the ER or doctor to begin treatment to prevent your heart muscle from dying due to blocked arteries. Once the heart is no longer getting a blood supply, there is no reversing the process and more of the heart muscle dies.
Women of all ages should take heart disease seriously.
Don’t delay in getting help, and most importantly do not just dismiss what you feel.
Doctors need to take a woman’s experience with heart disease more seriously. In return, women have to pay attention to their own bodies. Women should not minimize their symptoms or be stoic or feel that their doctor is going to tell them that it is anxiety. Oftentimes you may have the feeling it’s not worth it to go.
Heart disease is the number one killer of women! It’s essential that you pay close attention.
Know the risk factors that can increase your chance of a heart attack:
- High blood pressure
- High cholesterol
- Family history of heart disease
- Mental stress and depression
Learn the activities to help decrease the risk of heart disease:
- Lose weight
- Decrease stress
- Quit smoking
- Decrease cholesterol
- Decrease sodium
- Decrease the consumption of animal products
- Make women you know and care about aware of the risks
- Educate our doctors to be more perceptive and ask them to be more proactive to do work up
- Ask your doctor about daily ASA and Omega 3 fatty acids
Bill, by writing this letter to me, I know we can never replace your wife; but you have opened the eyes of many women out there by helping to raise their awareness to the number ONE killer of all women. Your letter provided insights about the many symptoms your wife experienced that were not typical heart attack symptoms. By doing so, it helped to bring to light important information that may save lives. Heart disease can affect women—and men of all ages. Because of your letter, you are helping me to spread the word of how this is a NOW problem, not one to be taken lightly or later on.
I appreciate your strength and concern, and thank you so much for writing to me. I hope my response has let you know that you did everything possible and more—by helping to increase everyone’s awareness and encourage women and families to be more informed and proactive in their care.
My thoughts are with you and your family, Dr. Christina
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