February 12, 2009


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Commentary: Matters of the heart

When it comes to matters of the heart, we know that men and women are different. These differences hold true when it comes to heart health, as well. Knowing how to recognize the early symptoms of a possible heart attack can help men and women — and their doctors — to prevent it, or intervene in time to minimize the damaging effects on the heart.

Good heart health is a combination of diet, exercise and knowing your risk factors for heart disease, as well as recognizing the signs of a heart attack. A heart attack rarely happens without warning — it’s up to us to identify the signals and act in time. In honor of American Heart Month and Valentine’s Day, do your heart a favor: learn the facts about how to keep your and your loved one’s heart healthy and strong.

If you’ve never had a heart attack, you may picture it as you’ve seen it depicted in the movies: the sudden, sharp chest pain, staggering and eventual collapse. Actually, the signs of a heart attack are much more subtle and are not the same for everyone.

Men usually experience what we know as the “classic” signs of a heart attack:  heavy squeezing or chest pain, discomfort in areas of the upper body (arms, back, neck, jaw or stomach), shortness of breath, a cold sweat or nausea.

Women suffering a heart attack sometimes experience chest pain, but not as frequently as men do — and, they experience other symptoms not generally linked to heart trouble: shortness of breath, nausea or vomiting, and back or jaw pain. Women also experience symptoms earlier: for men, symptoms usually come either right before, or during a heart attack.

Research by the National Institutes of Health indicates that women experience different physical symptoms as long as a month or more before experiencing a heart attack. In a 2007 study of more than 500 women, 95 percent of participants reported experiencing new symptoms at least a month before their heart attack, including unusual fatigue, sleep disturbance and shortness of breath.

Less than 30 percent of women studied experienced chest pains prior to the attack, and 43 percent had no chest pain during the attack. Other symptoms included indigestion and anxiety. The study was one of the first to examine the differences in the way men and women experience a heart attack.

Knowing the differences is important for many reasons. Women who experienced these non-traditional symptoms did not identify them as a heart attack and put off seeking medical attention — decreasing their chances for preventing, or surviving, the attack. The American Heart Association estimates that about 95 percent of sudden cardiac arrest victims die before reaching the hospital.

The reason these differences are just now coming to light is that heart disease has, for decades, been considered a man’s disease that did not generally affect women — so, research focused primarily on men. Cardiovascular disease, however, has claimed the lives of more women than men, every year since 1984.

Talk to your doctor today about steps you can take to educate yourself about heart health and any recommended health screenings based on your individual profile.

Remember that symptoms may come and go. Even if you’re not sure if it’s a heart attack, it’s important to be checked by a doctor. New medications and treatments are now available that can stop some heart attacks in progress and save lives — but these drugs must be administered at the first sign of heart attack symptoms, for maximum effectiveness.

During American Heart Month, take care of the ones you love. Knowing the symptoms of a heart attack and how to minimize its effects will help ensure that you and your loved ones are heart-healthy for many a Valentine’s Day to come.

Nicole Davis, MD, FAAFP, is a member of Chestnut Hill Family Care Associates in Wyncote.