Originally created 02/02/05

Women , doctors miss signs of heart disease



Like many women, it hit Barbara Stewart from out of the blue. She was convinced her doctor was being overly cautious by sending her to see a cardiologist, until the cardiologist looked over her tests and asked her about her heart attack.

"And it was just like you hit me in the face," said Mrs. Stewart, whose complaints had been aching arms and a pain in her back between her shoulder blades. "I really had no idea."

And Mrs. Stewart is not alone. Although about 350,000 women will suffer a heart attack this year, women are less likely to get life-saving procedures such as balloon angioplasty, said Alexandra J. Lansky, the director of clinical services for interventional cardiology at New York- Presbyterian Hospital/Columbia. Of the 1.2 million performed a year, less than 35 percent are done in women, she said.

A survey of 500 physicians nationwide found women are often assigned to a lower risk category than men with the same symptoms, said Lori Mosca, the director of preventive cardiology at New York-Presbyterian.

Another study of 9,000 women with high cholesterol and at high risk for heart disease found only a third were getting cholesterol-lowering drugs, Dr. Mosca said. The studies were published Tuesday in the journal Circulation and were part of an annual news conference by the American Heart Association calling attention to the lack of treatment for women.

"So taken together, these studies suggest to us that we can do a better job with respect to preventive care," Dr. Mosca said.

Part of the problem is women might present less familiar heart disease symptoms, such as sudden shortness of breath or fatigue, said Carolyn Landolfo, the director of adult echocardiography at Medical College of Georgia Hospital.

"There's a lot of overlap between symptoms of menopause and symptoms which potentially could be related to heart disease," Dr. Landolfo said, although women also can have the classic symptoms of chest tightness and radiating pain down the left arm.

And women might assume it won't get them until after menopause, but that's not true, said Abdulla M. Abdulla of Georgia Cardiovascular Associates.

"When you're getting to the age of 40 and you start having symptoms you've never had before, get it evaluated," he said. "If it is your heart, you may not get many additional opportunities to get it evaluated."

Even though her mother died of heart disease, Mary Frails, 57, also was shocked to find out what that hot, clammy feeling was she had last May. "I guess you don't picture yourself as having a heart attack," she said.

Since she had hers in March 2003, Mrs. Stewart, 69, has been spreading the word about the risk and working out at the Cardiopulmonary Rehab Center at University Hospital.

"I'm just fine," she said between exercises, "and I intend to stay that way."

Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.

DIFFERENT SYMPTOMS

The classic symptoms of a heart attack are chest pains and radiating pains down the arms, usually the left arm. While many women will have these symptoms, their heart disease could show up as something else. Among the other warning signs of potential heart disease are:

 •  Sudden shortness of breath or sudden weakness for no reason

 •  Unusual fatigue

 •  Sleep disturbance

 •  Nausea

 •  Headache or jaw pain

SHOW YOUR SUPPORT

The American Heart Association declared Friday National Wear Red Day. People are encouraged to wear red to raise awareness of women and heart disease.