Two heart attacks – two different types of pain

Is it heartburn? Muscle strain? Pain from a heart attack can take on different forms for women – and unfortunately, it’s those subtle differences that could be making a huge difference in clinical outcomes for patients.

Coronary heart disease continues to be the leading cause of death for women in the United States even though more is being done to identify and treat the disease. Ignoring the symptoms of heart attack is one of the key factors attributing to this statistic.

“Since the 1980s there’s been a steady decline in cardiovascular disease rates for women, and that’s great,” explains Dr. Michelle Carlson at Hennepin Healthcare. “Awareness of prevention efforts like reducing cholesterol, stress, and smoking cessation as well as incorporating positive exercise and diet choices are making a difference. But there’s one obstacle we’re still not overcoming – and that’s the likelihood of women to dismiss symptoms until it’s too late.”

Sandi Scott has survived two heart attacks as a result of coronary artery disease. One at the age of 34 and another when she was 42.

“The symptoms of each were very different,” she said. “With the first one, it felt like the pain was in my lung and it was not constant. But at times the pain was so severe that I would be curled up in a fetal position.”

When she was diagnosed with a heart attack and had a stent placed, her cardiologist was amazed at her survival.

“He asked me to explain how I had a 99 percent blockage and was still here,” said Scott.

When she experienced the second heart attack, she knew right away what was happening.

“I was in constant pain and it literally knocked me out,” she said. “I was at home and called 911. The next thing I remember was being hauled out by paramedics, and then coming to after the stent was placed.”

Scott wants other women to pay attention to any discomfort or pain they are feeling and address it right away.

“We are worth taking care of ourselves. We have to come first.”

She tried to convey this message to a friend who was experiencing chest pain, telling her that it was not going to hurt anything to get checked in the ER or call the nurse line. Her friend didn’t take her advice. The next day she had a massive heart attack.

“As women, we are so good at taking care of others and don’t want to feel like we’re wasting anyone’s time if there’s not anything wrong,” Dr. Carlson explains. “But we need to prioritize our health – and unfortunately when it comes to chest pain related to heart attack it can be difficult to identify in women. So let a health care professional check it out to be on the safe side.”

Some of the risk factors for coronary artery disease that can lead to a heart attack include age, family history, high blood pressure, obesity, high blood cholesterol levels and smoking.

Symptoms women may experience if they are having a heart attack include:

(From the American Heart Association)

• Uncomfortable pressure, squeezing, fullness, or pain in the center of the chest lasting more than a few minutes, or it 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.
• Other signs such as breaking out in a cold sweat, nausea, or lightheadedness.
• As with men, women’s most common heart attack symptom is chest pain or discomfort. However, women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.

Hennepin Healthcare has a long tradition of delivering patient-centered, high-quality cardiovascular care. Using the latest interventions, cardiac specialists at Hennepin Heart Center provide expertise in arrhythmia management, cardiac catheterization, rehabilitation, surgery, monitoring and imaging, and cardiac therapies.  Hennepin Heart Center is one of 8 regional centers comprising the Heart Failure Research Network established by the National Institutes of Health.  Visit hennepinhealthcare.org/cardiology for more information about Hennepin Heart Center.