Beatriz Martinez didn’t pay much attention to that first chest pang. After all, she worked out regularly, kept her weight in check and tried to eat a healthy diet. Her blood pressure and cholesterol numbers came in within the normal range, too.
So she didn’t think twice about her shortness of breath, and when she suffered a dizzy spell, she attributed it to a sudden movement. Even when the pain shot down her arm and her chest felt like it was burning, she tidied her house and went to dinner with her then-husband.
“It never occurred to me that I was having a heart attack,” said Martinez, a Kendall resident. “I didn’t think it was something that could happen to me.”
Martinez, however, ended up in the emergency room at midnight, where she was stabilized, and within hours was undergoing heart catheterization. She learned that her aorta was completely blocked. A medicated stent was placed in the narrowed blood vessel.
Though that frightening episode happened in 2012, it taught Martinez, who turns 60 in February, a valuable lesson: “Women don’t pay enough attention to [heart attack] symptoms. They take care of everything but themselves.”
Martinez’s current cardiologist, Dr. Alvaro Gomez with the Miami Cardiac & Vascular Institute of Baptist Health South Florida, says her case is not uncommon. He sees women who don’t recognize the symptoms of a heart attack or simply dismiss telltale signs. They attribute “non-traditional” heart attack symptoms such as dizziness, vomiting and shortness of breath, to indigestion or working out too hard.
“Up until recently heart disease in women was an almost all but overlooked topic,” Gomez explained. “For a long time clinical trials only included men. There simply wasn’t the awareness.”
This unfamiliarity continues to exist, even within the healthcare community, says another top local cardiologist, Dr. Maureen Lowery, an expert on women’s heart health at the University of Miami Health Systems. Lowery recently saw a 51-year-old woman with a high risk factor for heart disease: Type 1 diabetes. However, the woman had never been sent for a single cardiac study before coming to Lowery’s office.
Women’s heart health problems, she added “are unfairly diagnosed and treated. Their symptoms are taken less seriously even now. There is a definite gender and racial bias.”
This is a problem. According to the Centers for Disease Control and Prevention, 1 in 5 women dies from heart disease every year, with the most common cause being the narrowing or blockage of coronary arteries, the major reason for heart attacks. “Heart disease,” Gomez added, “is the number one cause of death for women. It by far exceeds all cancers, including breast cancer.”
Women aren’t aware of the danger. “When they come in, they’re surprised that it’s a heart issue,” said Dr. Lucia Blanchard, cardiology specialist and internal medicine physician at Broward Health. “They think they’re dehydrated or having indigestion. They think that the pain will go away and they can wait it out.”
That, of course, is a big mistake. Ignored and untreated, a heart attack can result in extensive damage or, worse, death. But treated properly, women — and men — can go on to survive heart attacks.
Diagnosing and treating heart disease in women is further complicated because women often don’t manifest signs in the same way as men do. “It’s very important to recognize the symptoms [of a heart attack or stroke],” Blanchard added. “And it’s important to act quickly.”
Watch out for a heavy or sharp pain in the chest (even discomfort) as well as neck, jaw or throat pain, abdomen or back pain, nausea, vomiting, heartburn, dizziness, shortness of breath. General heart disease symptoms can also include fluttery feelings in the chest and swelling of the feet, ankles, legs, abdomen or neck veins.
Women also tend to suffer more than men from certain heart diseases, according to the National Heart, Lung, and Blood Institute. These include irregular heartbeat (arrhythmia), coronary microvascular disease (MVD), which affects the heart’s tiny arteries, and broken heart syndrome, when extreme emotional stress can lead to severe heart muscle failure.
What’s more, the older a woman gets, the higher her risk of heart disease, especially in the post-menopausal period of later life. “That’s when they begin to lose the protectiveness of estrogen,” Gomez explained. “And now since we’re living longer, it means there are more years spent under that risk.”
Cardiologists and other health professionals tell women that there are plenty of things they can do to prevent and control heart disease. Organizations are working hard to raise awareness of the disease. These include the American Heart Association and the WomenHeart Support Network, which both Gomez and Beatriz Martinez are active in. WomenHeart hosts monthly meetings, both in English and Spanish.
Women need to know the risk factors: high blood pressure, diabetes, obesity, high cholesterol, smoking and menopause.
In Martinez’s case, she didn’t suffer from any of these common risk factors except for a long and troubled family history of coronary disease. Because your cholesterol number alone isn’t enough to eliminate risk, Gomez suggests a cardiac calcium scoring test, a noninvasive CT scan that measures calcium buildup in the artery walls.
“The most important takeaway,” Gomez added, “is awareness. Women need to understand that heart disease is their number one killer — but it’s also very treatable.”
What can you do to protect yourself from heart disease?
Stop smoking.
Eat a healthy diet.
Exercise.
Lose weight, especially around the middle.
Control your blood pressure.
Manage your cholesterol.
Reduce your blood sugar.
Limit your alcohol intake.
Learn to manage stress.