Can't Strike Women? Heart Disease Knows No Gender
By Liv Osby
Stephanie Brown was getting ready for church one Sunday morning when she began feeling strange.
Short of breath, sick to her stomach and hot, she thought maybe it was the flu or some kind of stomach bug.
But when her husband, Johnny, took one look at her, he realized he had to get her to the ER fast.
At the hospital, after vomiting on the way, the mother of two got worse. So an electrocardiogram was performed which concluded she was having a heart attack.
"I remember looking at my husband like, ‘You've got to be kidding me.' I'm 43 years old. I can't be having a heart attack," she said.
From there, the Pickens woman was sent for a cardiac catheterization. But when she awoke, thinking the problem had been resolved, she said she was told that they couldn't find anything wrong and was sent home.
For the next week, though, the symptoms persisted and were increasing in frequency, she said. There were times she couldn't take a breath.
Her father referred her to his cardiologist where another ECG was performed. Shockingly, she said, it revealed that just while she was there, she'd had three heart attacks.
Rushed by ambulance to the hospital, another catheterization was performed. This time, she said, a blockage found in one of her arteries was stented to restore blood flow.
As unusual as Brown's story sounds, it's not that uncommon.
That's because there continue to be misconceptions about women and heart disease, the often atypical symptoms they experience, and misdiagnosis, health experts say.
"Many times women are considered to be at lower risk for heart disease, but they die at about the same rate as men do," said Dr. Brent Egan, an internist and professor of medicine at the University of South Carolina School of Medicine Greenville and adjunct professor of medicine at the Medical University of South Carolina and public health sciences at Clemson University.
"There's a lot of focus on breast cancer," he added."But heart disease is the No. 1 cause of death in women."
Nearly 300,000 women die of heart disease in the U.S. every year, according to the American Heart Association.
In fact, heart disease claims one in three women's lives, said Kelly Wilkins, executive director of the American Heart Association of the Upstate.
"When we think about what that's doing to our community, to the people we know and love," said Wilkins, "that's a devastating number."
Women may not have the classic symptoms, such as sharp chest pain or a heaviness like a weight on the chest, said Egan. They may just have nausea, sweating, weakness, awareness of their heartbeat or a sense of impending doom, he added.
"The tendency is to say it will go away. It's just indigestion," he said. "But if people have a sense that something's not right, they should go with their instincts and get prompt medical attention."
He advises anyone who thinks they're having a heart attack to take an aspirin and head to the ER, adding that the coronavirus should not keep them from going.
"Many people, especially during this unfortunate pandemic, their stress level rises, which is a huge contributor to heart attack and stroke," said Wilkins. "We want to encourage people who are experiencing symptoms of heart attack or stroke to seek help. Now is not the time to step back from that."
Women in general wait at least 30 percent longer from their first symptoms before going to the hospital, Wilkins said. They're often misdiagnosed as well, with symptoms often attributed to anxiety, she said. They're less likely to receive CPR too.
"Sometimes physicians are under the impression that (women) are not high risk," Egan said.
One of the reasons is the lack of research.
Recognizing the dearth of information about women and heart disease, the heart association in 2004 started the Go Red for Women movement to raise awareness and funds to support research, Wilkins said.
"If we don't know how it affects women, we aren't as able to prevent it," said Anne Marie Maertens, who is chair of the AHA Upstate's Go Red for Women event this year. "And we need to treat, beat and prevent heart disease in women."
African Americans are hardest hit, Wilkins said.
Some 57 percent of black women, compared to about 43 percent of white and Hispanic women, have heart disease, she said.
"Unfortunately, heart disease claims the lives of more black women than all forms of cancer and accidents combined," she said.
People of color may live in vulnerable communities where access to healthy food, physical activity, transportation and health care, along with the daily stress, can contribute to heart disease, she said.
"We at AHA are working on identifying disparities, especially in Upstate communities," Wilkins said. "It's horrifying to think about women overall, but when you bring in the disparities ... this truly is something we can come together on and help change."
The heart association also launched the Research Goes Red campaign to empower more women to contribute to research, where again women of color are under-represented - black women make up just 3 percent of all female research participants globally, she said.
This year's Go Red for Women event is expected to take place this fall, said Maertens, whose father's heart disease puts her at increased risk.
"This is a gathering for women to learn, understand and hopefully become ambassadors for heart health in women," she said. "And we know that women of Hispanic and African American descent are at increased risk ... so we need to do even more to raise awareness and educate."
The good news is that heart disease can be prevented through lifestyle changes - such as not smoking, eating a healthy diet and exercising - along with effective medications, said Egan, who also serves as vice president of cardiovascular disease prevention in the Improving Health Outcomes division at the American Medical Association.
"Even if there is a strong family history, lifestyle makes a tremendous difference," he said, adding that women who don't have a family history should not assume they're protected.
Those lifestyle changes can also lower the chance of high blood pressure and diabetes, which can increase the risk for heart disease, said Wilkins.
"More than 66 percent of women are overweight or obese," she said. "And only one in five women is getting the recommended amount of exercise."
"The most important message here is for women to realize that the No. 1 reason they die is heart disease," said Egan."It's important to have a healthy lifestyle and good medical care."
Brown's brush with a heart attack occurred five years ago, when she was a fit and physically active horsewoman.
She's been fine since and became a Go Red for Women spokesperson to raise awareness.
"I wanted to tell the story that the things you see on TV aren't necessarily what happens in women," she said. "And about 50 percent of the population doesn't even recognize that heart disease is the No. 1 killer of women. Most women still think it's breast cancer."
Now 48, Brown was back at work within two weeks of the procedure as the program director/instructor of veterinary technology at Tri-County Technical College in Pendleton.
"After they placed the stent, I felt like new again," she said. "But I could have easily been a statistic."