It began for Nellie Hyacinth Davis with a cough.
“I had this terrible cough,” said Davis, 79. “But I didn’t get no tightness or nothing where I could say it’s my heart.”
Barely able to breathe, she eventually ended up at Georgia Regents Medical Center, and finally doctors turned up blockages in her coronary arteries that resulted in two stents being placed to keep those blood vessels open.
“Everybody asked me in the hospital if I had pain,” Davis said. “And I never had pain in my chest.”
That is not unusual. Women with heart disease or even heart attacks often have different symptoms than men and even different disease than men, which often means taking a different approach, physicians said.
The American Heart Association has designated Friday as National Wear Red Day to help promote awareness of heart disease in women, which is the No. 1 killer of women. Once thought of as a man’s disease, the message that it isn’t has gotten through in recent years, said Dr. Sheldon Litwin, the chief of cardiology at Georgia Regents University.
“There’s no question that today most people do know that this is a women’s disease and are much more aware of it,” he said. “It used to be, if a woman came in with chest pain, it was assumed that it was not their heart and they would do other testing. Today, I really don’t think that’s the case anywhere. There’s no doubt that the public education and awareness has changed.”
Part of that is recognizing women might have different symptoms and that even the disease itself might be different. For years it was thought that women did not get invasive procedures as often as men due to bias. But one large study looked at 1,000 women who had abnormal readings from a stress test and were then given catheterizations and surprisingly 70 percent did not have the significant obstruction in the artery that might have been found in a male patient, Litwin said. Those women would probably not benefit from the standard treatment of catheterization and then a stent to keep the artery open but might be better served by addressing some of the underlying causes, such as obesity, sleep apnea or getting diabetes under control, he said.
Women in general get less exercise than men and have higher rates of obesity and severe obesity that can increase their risk of cardiovascular disease, Litwin said. But younger, premenopausal women appear to be better protected against cardiovascular disease, at least up to menopause. Why that is, and how to extend that benefit past menopause is “very, very controversial,” Litwin said, and has been the subject of numerous longterm studies. The bottom line is heart disease risk, how to recognize it and treat it, will be different in women, he said.
“That’s been part of our problem is that we have looked at everybody the same way,” Litwin said. “One size doesn’t fit all when it comes to both the symptoms and the diagnostic approach.”
Since her procedure and since she started taking new medications, Davis said she has lost 11 pounds and is feeling much better. Her appearance delighted cardiologist Gyanendra Kumar Sharma when he walked into her exam room.
“You’re looking good,” he said, bending over to examine her legs. “No swelling and legs are beautiful.”
“I feel good, too,” Davis said.