Too young for a heart attack?

Heart disease can seem so distant, so unreal, and something you don’t have to worry about.

Unfortunately, it is very real, especially for women.

There’s no time like the present to start assessing your own goals on how you want to age and how you can enjoy better heart health. Where do you stand on meeting your goals? If having a heart attack is not something you want to experience, you need to act now.

Having a health goal is important and also the key to staying healthy as you age.

Making health changes such as exercising daily, changing eating habits, and practicing stress-reduction techniques can be challenging, especially if you don’t start with a clear goal.

When my patients say, “I can’t believe you are asking me if I want a heart attack; of course I don’t want a heart attack,” I show them how their actions speak louder than their words. By choosing not to exercise, eating high-sugar foods and allowing stress to rule their lives, they are actually choosing a heart attack.

The good news is that it’s never too late to get healthy, but the sooner the better.

A patient I’ll call Adrienne is living proof that heart disease can affect just about anyone.

At age 39, she suffered a heart attack—way too young—or so she thought. Adrienne was going through a very stressful time in her life and was having shortness of breath occasionally.

Adrienne thought being winded had to do with the stress she was experiencing or maybe because she was tired and had not been eating well. She would simply rest until she felt better and forget about the feeling until it would happen again. Adrienne never even considered she might be having a heart attack.

However, one day the feeling came back and persisted for a long time. When she received some especially bad news, her breathing became very labored, and she knew something wasn’t quite right. She mentioned her symptoms to her husband, and he insisted they go to the ER immediately. Just minutes after arriving at the ER, Adrienne had a full-blown heart attack.

Fortunately for Adrienne, the ER staff took her symptoms seriously. She is alive today thanks to the prompt and expert care she received that day.

Not everyone is as lucky as Adrienne.

More women die of first heart attacks

Many women don’t get help quickly enough or they are not taken seriously when they go for help. But the facts don’t lie: More women than men die from their first heart attack and more women than men have fatal heart attacks.

As Adrienne went through cardiac catheterization, open heart surgery and cardiac rehab, she learned she had risk factors for a very long time, but never realized it. As a result, she never received the preventive treatment needed to prevent a heart attack, and she wasn’t aware of the early symptoms.

Adrienne’s shortness of breath and fatigue had been going on for more than a month, but she never knew the severity of her condition.

Adrienne began to learn more about her health and important risk factors of heart attacks. These include family history, cholesterol levels, blood sugar levels, high blood pressure, obesity, smoking, diet, high stress, inactivity, inflammation (which can be caused by diet and the presence of heart disease), and age.

In addition, activity and increased stress level can affect your risk of having a heart attack. Adrienne had risk factors she never knew she had.

Unfortunately, Adrienne’s story isn’t unique.

Too many women either don’t know the warning signs of a heart attack or ignore them because they don’t want to bother anyone.

Know the symptoms

It’s important that we know the signs and symptoms of a heart attack, especially because they are different in women than men.

Men tend to experience a heaviness, like an elephant, on their chest. They also notice a true pain in their chest that radiates to the left arm and up the neck.

Women tend to have more subtle signs. The most common symptoms for women are progressive shortness of breath on exertion or with great stress, unexplained fatigue, nausea, subtle chest heaviness, neck pain, or arm pain.

I have had patients who dismissed some of their symptoms as jaw pain from TMJ or simply sleeping funny. I have even seen patients who presented with new onset hot flashes years after menopause. After sending them to a cardiologist, they find out they have angina and they ended up with heart surgery instead of hormones.

Risk scores also help physicians predict your chances of having a heart attack in the next year, and even in the next 10 years. My favorite scoring system is the Reynold’s Score, and it can be done at home by going online to reynoldsriskscore.org.

You will need to know your family history, total cholesterol level, HDL cholesterol level, systolic blood pressure (number on top), and C-Reacting Protein (CRP) level. You will also be asked if you smoke, which is a significant cause of heart attacks.

Other tests used to assess risk include an ultrasound of the artery in your neck to determine your risk of stroke, and a CT scan of the chest to look for calcium in the artery walls.

When you have symptoms, it is important to have two tests performed: an EKG to see if your heart is suffering low oxygen from blockages, and a stress test with an ultrasound of the heart (ECHO). If you are experiencing symptoms such as chest heaviness or shortness of breath, you will want to go to the ER or call 911.

In our clinic, we use risk scores, including the Reynolds Score, to score for Metabolic syndrome. This syndrome is a strong predictor of experiencing a heart attack or stroke.

If a woman comes to us for hormone therapy and also has Metabolic syndrome or is at high risk for a heart attack, we will not prescribe hormone replacement therapy as it would put her at greater risk for a heart attack. However, if she is at low risk and does not have Metabolic syndrome, hormone replacement therapy can actually lower her risk of having a heart attack or stroke.

In the not-so-distant past, it was common for women to go to the ER with chest pain and shortness of breath, only to be told it was heartburn or an anxiety attack. It was even thought that women couldn’t have heart disease.

Fortunately, health care experts now take this issue seriously, and we are very aware that heart disease affects both men and women.

We wish that every woman knew her risk factors and made healthy choices to avoid suffering a heart attack. Too many women (and their families) suffer an unnecessary loss. Take control before it happens to you.