“Women Are From Venus, Men Are From Mars”!

Remember that episode of Grey’s Anatomy when Miranda Bailey went to another emergency room to get help for her chest pain? Her mental health issues and life stressors were all brought into question and she rightly said, “”Do not go down that road with me: The road where a woman shows up in an ER with physical symptoms, and you decide that it must be that she’s not able to handle all her feelings. No, this is not about anxiety. My secret heart doesn’t need fixing. My actual heart needs fixing.” Oh what an icon she is! And yes – she knew her medicine and her body well!

Women and men are not only wired different emotionally, but they also react differently to various physical stressors and diseases. They even show different physical signs and symptoms for similar illnesses. February being the American Heart Month, I thought it would be a good idea to highlight the differences in warning signs of heart diseases as they present very differently in women compared to men.

Heart disease is generally perceived as a men’s disease but in reality it is the number one killer of BOTH men and women in the United States. In fact, heart disease kills more women than all cancers combined! Younger women with heart attack also have higher death rates during hospitalization, than men of the same age. A recent study published in the Journal of American Heart Association elucidates a specific kind of heart attack with nontraditional risk factors and presenting symptoms (called MINOCA). That particular variant of heart attack affected more younger women, showed varied mechanistic profile but behaved very much like traditional heart attack in terms of mortality, functional and psychosocial status. Therefore it is crucial to understand the disease, its presentation and then being your own advocate in demanding care, as current health-care system may be dismissive of your concerns.

First all, symptoms of heart disease in women are more likely to be ignored and/or misdiagnosed thereby leading to delays in getting appropriate treatment. But why is that so? Many of us know women who stay away from ERs even when they are having symptoms because of fear of being labeled hypochondriacs. And their fears are justified. Research shows that women’s physical symptoms are more readily interpreted as psychological (anxiety/panic attacks) while the same symptoms in men are considered organic and real.  Also they are more likely to be diagnosed with indigestion or back pain when they complain of chest discomfort, being unwell or “achy”.

American Heart Association lists the following as warning signs of a heart attack in women:

• Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
• Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
• Shortness of breath with or without chest discomfort.
• Breaking out in cold sweat, nausea or lightheadedness.
• Extreme or unusual fatigue after a simple task
• Fainting

As you can tell, these signs are usually not as pronounced and dramatic as we see in ads and movies. Most of us associate chest pain after physical exertion as a sign of heart attack. In contrast, women can develop symptoms at rest, or even while sleeping, and mental stressors can trigger those symptoms as well. Signs of a major heart attack in women therefore can be subtle, but the outcome of any heart attack can be fatal, especially if evidence based treatment protocols are delayed.

“Call me crazy – hysterical even – but I don’t think you should have to feel empowered just to receive proper medical treatment”. Maya Dusenbery

If you or a loved one around you are experiencing any of these symptoms, call 9-1-1. Many women notice one or more these warning signs, on and off, for few weeks before an actual heart attack happens. If any of these signs are happening intermittently, do report your symptoms and concerns to your medical provider and push for further work up.

You can reduce your risk factors by quitting smoking, eating healthy and staying active. You can read further about healthy choices and lifestyle at Voicebowl. You can use this simple Mayo Clinic calculator to assess your risk for heart disease. American Heart Association has great tips for a healthy Valentine’s Day that you can celebrate with your sweetheart/s. And of course, you can certainly make them happy by using Maj’s Valetine’s Day gift guide.

Stay empowered, enjoy your day with family and friends and play healthy!