Women's Heart Attacks: How I Missed the Signs

Hypertension is aptly dubbed the silent killer. Especially in women. In June of this year I had a heart attack, having misread the signs of impending trouble. Though both my parents succumbed to cardiac diseases, and I have chronic hypertension, I somehow thought this could never happen to me. None of the classic signs were present:

Pain radiating from the left shoulder down the arm

Nausea

Crushing chest pain

Sweating

Breathlessness

Fainting

Chronic hypertension can create significant damage if left untreated, to the eyes, heart and kidneys. And unfortunately, many women suffer from chronic high blood pressure for years before getting proper treatment. In this I was lucky. Due to a traumatic ankle fracture, my blood pressure became highly unstable, with a regular reading of 190/110. How did the doctors relate this to the injury? Because every time heavier pain medications were given, my blood pressure dropped and stayed that way while taking them. While the medications used to treat chronic hypertension had little or no effect. In June I had been on Toprol XL, Lotensin, Triam HCTZ and Zetia for well over a year. And those BP numbers dropped very rarely or for long.

Because chronic hypertension can create a wide range of symptoms, it is too easy for many women to completely miss real trouble brewing. According to heart.org, here are the symptoms you can experience with chronic hypertension:

Dizziness and fainting

Flushed face

Sweating-often excessive

Palpitations

Headaches-sometimes severe

Nosebleeds

Double or blurred vision

Chest pains

Nocturia

Anxiety

Fatigue

Needless to say, I had quite a few of these symptoms in the month preceding my heart attack. And looking at this list, it is fairly easy to see how so many women misread the signs. After age 40, women can begin experiencing signs of perimenopause, which encompasses feeling lightheaded, perspiring excessively, having headaches and more. If there are pre-existing conditions such as diabetes, anemia, stress, or autoimmune disorders like Lupus or Crohn's Disease, the picture becomes much cloudier. What happened to me, they tell me, was a classic misread of the signs of female heart attack.

In May I started having moments of truly severe dizziness. The room would actually feel like it tilted. I called my physician, who suggested it might be the medications and to start jotting down frequency and times they occurred. The problem was these episodes lasted literally seconds and happened less often than twice a week. I also began experiencing what I thought was another bout with acid reflux, another common misread of symptoms. Only this was fairly different from anything I had felt before. So, assuming it was a newly developing bout with it, I started back on Protonix and it seemed to help. The difference was the pain was very localized and was like a very tiny burning in the center of my chest. It was there but was really not that bothersome.

As the month wore on, this just stayed, never varying in intensity, but the lightheadedness continued. Plus, my fatigue level increased dramatically. Just recovering from a major flare with lupus, I put the fatigue down to the battle my body had just been through. Then in June, two days before the event, the chest pain increased dramatically, and began radiating down my left arm. Again, because with acid reflux, I had had these same symptoms, I put it down to that. But on the morning I called the ambulance, there was no mistaking the signs of sweating, crushing chest pain, pallor and nausea.

Even then though, I was hesitant to call and "bother" the paramedics, thinking this might be transitory and possibly lupus induced. They ran an EKG strip, took one look and I was out the door. Being familiar with emergency medicine, I was totally aware that this was very serious by the urgency of their actions. Having started the IV's, they continued running strips during the very quick ride to Mercy Hospital, and I was immediately whisked to nuclear medicine for a total body and cardiac scan. An X -Ray had been done the minute I hit the ER of my lungs, just prior to going downstairs.

The doc came in once I returned and told me I was staying and that I had had a heart attack due to as yet unknown causes. They had morphine running to lessen the chest pain along with heparin to dissolve any blood clots during my stay. After MRI's and CAT scans, an echocardiogram revealed the cause: cardiac hypertrophy due to chronic hypertension. My cardiologist, Dr. Breen explained that this is a thickening of the main valve to the heart and needed aggressive treatment to halt any further damage. He told me that women are so terribly vulnerable to cardiac issues like hypertrophy or myopathy, because they tend to misunderstand what their bodies are trying to tell them.

We all as women, get fatigued, suffer from momentary dizziness, headaches, acid reflux or bouts of excessive perspiration. And we all tend to minimize or attribute these these things to other causes. Because we are by nature the caregivers and nurterers of family and friends, we all too often ignore our own health needs, never thinking twice about it. We owe it to ourselves to be much more aware and proactive about our own health. That means, especially after age 40, getting regular blood pressure checks. If you have a history of familial cardiac problems, be especially watchful of your cardiovascular systems. Buy a home BP kit and monitor your blood pressure daily for two weeks. If it is under 140/70 during that time, count yourself lucky and repeat every 3 months. If you can catch developing high blood pressure early enough you will significantly ease the methods of treatment. Often diet, exercise and stress reduction are enough to effect big changes.

If you have pre-existing diseases or have suffered major trauma, monitoring becomes critical to your overall health. Chronic pain sufferers often have a difficult time keeping up a healthy blood pressure reading, because pain will often raise blood pressure significantly, all on its own. Our health is in our hands. Until women become advocates for their own cardiovascular health, we will continue seeing many more women die needlessly, because they did not understand what their bodies were telling them. This New Years, make this one of your key resolutions for 2009. That you will, unlike me, take your health issues in hand and become a much healthier and aware woman.