Taking the Message to Heart

Beyond Awareness About Women's Hearts: What About Yours?

It is safe to assume that the facts about women and cardiovascular disease circulated by massive public awareness campaigns have reached you by now. You know: that heart disease kills more women than anything else, that it's six times more deadly than breast cancer, more deadly for women than it is for men, yet under-recognized, under-studied, under-treated and under-funded.

So it's time to pick up where the awareness leaves off -- with what you can do about any of it. Knowing the statistics is fine, but it's better to know how not to become one. We've culled expert opinions and recent study findings to help you figure out whether you're at risk, what your symptoms might look like and what to do.

Okay, I keep hearing that heart attack symptoms are different for women. Tell me what to look for -- and don't tell me nausea and fatigue. If I went to the hospital every time I had those, I'd have a private suite in the ER.

First, don't forget that many of the symptoms are the same for you as they are for men. If you feel like there's an elephant sitting on your chest, get help fast, lady. The pain may feel like crushing, squeezing, burning or a fullness in the center of the chest. It may radiate to the neck, one or both arms, the shoulders or jaw. It may go away and return. If this happens, chew an aspirin (uncoated, ideally) and get yourself to a hospital. But you also need to look out for the more subtle signs that some women have -- like shortness of breath, back or jaw pain, and . . . yes, nausea or vomiting. Some women think they have the flu or heartburn when they actually are having a heart attack.

So how can I tell the difference?

"You really can't. That's part of the problem in terms of people getting to the hospital on time," said Kathleen King, a professor at the University of Rochester School of Nursing who co-authored a recent study comparing heart attack symptoms in men and women.

She said unless they have chest pain -- and 30 percent of people have heart attacks without any chest pain -- women often attribute heart attacks to something else. (Here's that lack-of-awareness problem hitting home.)

"I would discourage trying to give women a list of symptoms that would cause them to sit at home and self-diagnose. Symptoms of heart attack are more unique than most people realize."

Oh, come on. Of course we're going to self-diagnose. How else are we going to decide whether to call for help?

All right: If you're vomiting profusely, have fever and diarrhea, it's probably not a heart attack, King said: "Most people don't have a lot of vomiting, it's more of a nauseous feeling."

Another important point: Women often describe what they feel during a heart attack as chest discomfort rather than pain. (Having gone through childbirth, many of us have a different reference point for pain than guys do.)

King said throat discomfort is another common symptom in women. It's not a cold-type sore throat, but a "heaviness in your chest that goes up into your throat."