Yes. . . Young Women Can Have Heart Attacks!
by Linda Carroll
Not too long ago I was told a terrifying tale about a young woman and a heart attack. The 40-year-old woman arrived at the emergency room of her local hospital displaying a multitude of symptoms that made it clear that a heart attack was in progress - at least it was obvious to a nurse in the ER.
After hooking the woman up to medications to help deal with the attack, the nurse alerted other doctors to the case and then went home at the end of her shift figuring all was well. When the nurse returned to work the next day, she was shocked to discover that doctors in the ER had stopped the medications, told the woman she was simply having a panic attack and sent her home. The woman suffered major damage to her heart.
Unfortunately, many doctors don't suspect a heart attack when they see a young woman with chest pain. And, while it's true that heart attacks are more common among young men than young women, women are not exempt . Figures from the National Center for Health Statistics show that in 1998, approximately 11,000 women under the age of 45 were hospitalized for heart attacks.
When a heart attack strikes a young woman, she is likely to suffer debilitating damage or die. In a study that looked at gender differences among heart attack victims, researchers found that heart attacks were far more likely to be deadly if the victim was female. In fact, when Dr. Viola Vaccarino and her colleagues looked only at patients under age 50, they found that twice as many women as men died in the days following a heart attack.
Part of the explanation for this frightening statistic is that young women with heart attacks often get either no treatment or they receive delayed care. Sometimes women, and sometimes their doctors, miss the attack because they don't realize that the symptoms of a heart attack may vary with the patient's gender, says Vaccarino, an assistant professor of epidemiology at the Yale School of Medicine. Compared to men, during a heart attack women are much more likely to experience back pain, indigestion and nausea and/or vomiting, rather than chest pain, as their symptoms, according to an earlier study by Vaccarino.
And while the bigger teaching hospitals are beginning to catch on, it's still not uncommon for doctors at smaller institutions to miss heart attacks in younger women, says Dr. Marianne Legato, founder and director of The Partnership for Women's Health and a professor of clinical medicine at Columbia Presbyterian Medical Center in New York City. Legato recently reviewed the records for a young woman in her 20s who showed up at a hospital complaining of nausea and vomiting, as well as chest pain. The possibility that the woman might be having a heart attack never occurred to the doctors examining her. She was dead within 48 hours.
When Vaccarino and her colleagues looked at death rates from heart attacks in young people, they found that misdiagnosis and delays in medical care could only explain part of the discrepancy between men and women. This is an area that needs further research, she says.
But, while doctors are at a loss to explain why heart attacks occur in otherwise healthy young women, they have pinpointed a group who are at an elevated risk. Women who smoke, are obese, have diabetes and/or high blood pressure are more likely than others to have a heart attack, Legato says. "And diabetes is a much more important risk factor for women than men," she adds. "Once you have it, your risk for [heart disease] is four to six times higher."
Ultimately, women need to know the signs of a heart attack and demand proper care if they think they may be having one. If you have risk factors for a heart attack, no matter whether you are in your 20s or 30s or 40s, and you feel you are experiencing a heart attack, don't allow the doctor to dismiss your symptoms as indigestion or anxiety. Tell them you want to be tested. If you don't, the consequences could be deadly.
The following symptoms could signal heart ills:
Angina (chest pain). Can also include back pain or deep aching and throbbing in the left or right bicep or forearm.
Breathlessness. Also may include waking up having difficulty catching one's breath.
Clammy perspiration.
Dizziness. Unexplained lightheadedness, even blackouts.
Edema. Swelling, particularly of the ankles or lower legs.
Fluttering. Rapid heartbeats.
Gastric upset (or nausea).
Heavy fullness. Also may include pressure-like chest pain between breasts and radiating to left arm or shoulder.