Many women ignore or dismiss the early symptoms of a heart attack, even though it's their leading cause of death. New research published by Yale on Tuesday helps explain why:
They’re misinformed, hesitant, embarrassed — and not taken seriously when they do seek help.
“I felt like, oh my gosh, what are all these people in the ER thinking of me?” said a 47-year-old heart attack patient in the study. “I’m not gonna go in and be embarrassed by having them tell me it was a gas bubble.”
Another patient called her doctor with symptoms and was given a general health appointment — with a five-day wait.
The patient interviews highlight a need to educate and empower women to recognize their symptoms and seek care, said lead author Judith Lichtman.
"Young women with multiple risk factors and a strong family history of cardiac disease should not assume they are too young to have a heart attack," Lichtman said in a statement.
Heart disease is the top cause of death for men and women, with more than 600,000 total deaths each year. While heart attacks are less common in women younger than 55, they are more likely to die from it compared to men of the same age.
For the study, Yale School of Public Health researchers conducted in-depth interviews of 30 women (aged 30 to 55) who had a recent heart attack. The patterns that emerged were:
- Their symptoms were variable, ranging from discomfort in the chest, neck and jaw to more general symptoms like sweating, anxiety, fatigue or dizziness.
- Women were not aware of their risk of heart disease and didn’t consider it as the cause of their symptoms.
- They hesitated to find emergency care in part because of work and family responsibilities.
- Some worried about the response from their families and medical professionals if it was a false alarm.
- They tried to treat their symptoms themselves.
- Even when heart attack symptoms were typical, healthcare workers didn’t take them seriously.
- Many didn’t have strong communication with their doctors.
“We heard incredible stories about how healthcare providers and families either hindered or helped the response,” said researcher Leslie Curry.
The study shows the need for further research on women and better training of health professionals to be aware of their issues, Curry said. The goal is for women to be better informed and not feel judged for a false alarm.
She said it's also time to ditch the classic “Hollywood” heart attack — a man clutching his chest in pain. For many women, that's not what a heart attack looks or feels like.
Women's knowledge of heart attack symptoms is improving but still low. A little more than half of all women understand that heart disease is their greatest health threat, according to the American Heart Association.
In 1997, less than 10 percent of women knew that.
"We want to make sure the risk for young women is on the radar," Curry said.
The study was published in the journal Circulation: Cardiovascular Quality and Outcomes.
According to the American Heart Association, the most common signs of a heart attack in women are:
- Uncomfortable pressure, squeezing, fullness or pain in the center of the chest.
- Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
- Shortness of breath with or without chest discomfort.
- A cold sweat, nausea, vomiting or lightheadedness.
Gavin Stern is a national digital producer for the Scripps National Desk. Follow him on Twitter at @GavinStern.