Heart Disease: A Woman’s Story
By Susan Butler, RN
I spent most of my career as a nurse in the emergency room and on a critical care helicopter so I’ve seen plenty of trauma, from car accidents to gun shots, and yes, plenty of heart attacks.
We all know the classic heart attack symptoms, or think we do – that crushing, radiating chest pain combined, maybe, with nausea and a cold sweat. True, those are the common symptoms in men. But in women, the symptoms may be less dramatic. Unfortunately, too often women don’t realize they’re having a heart attack because they don’t know a woman’s symptoms. Chest pain in a woman may be milder, less intense than in a man. She may feel tired. Her jaw or back may hurt. She may feel short of breath, nauseated or hot. And because the symptoms are so much more subtle, women often ignore them.
Heart disease remains the leading cause of death in women – ahead of all cancers, accident and stroke – killing more than 400,000 women a year. Rarely would a woman ignore a lump in her breast, and she shouldn’t. By the same token, she shouldn’t ignore the warning signs of heart attack. But a woman may chalk up fatigue, mild chest pain and shortness of breath to a long, hard week. Who doesn’t feel tired some days? She may imagine that the sudden sweat is just another symptom of menopause or she may think that she’s being silly to call for help.
So women – mothers, sisters and grandmothers – pay attention to the warning signals. I know you can’t head to the emergency room every time you feel exhausted, but if you’re suddenly so tired you can’t walk across the room, your chest hurts and you feel nauseated, you may be having a heart attack. Call 911. And be sure to say, “I think I may be having a heart attack.” Women are known for trying to talk their health-care professional out of the fact that they’re having a heart attack. Don’t make that mistake. When you get to the emergency room, tell someone that you think you may be having a heart attack to make sure that you get the most aggressive heart disease treatment available.
Heart Disease Prevention
I’ve been there in the emergency room with women. These days I practice a different kind of nursing. I run the Women’s Heart Health Program at Wake Forest University Baptist Medical Center, where I counsel women at risk for heart disease on the importance of prevention. One in three women have some form of cardiovascular disease. Some risk factors can’t be controlled. A woman can’t change her age, family history or race, but she can change her lifestyle. That’s where I come in. I do a full screening including an EKG, blood pressure, blood sugar and cholesterol check, waistline measurement and a body mass index (BMI) calculation. I educate women on how making small changes and setting reasonable and attainable goals can extend their lives. Then together we develop a plan for heart disease prevention.
I find patterns in women’s lives. Women feel they don’t have time to exercise. They are juggling jobs and family. Many women look after children at home and help take care of elderly parents. So they eat on the run, and fill up on fast food. Or they smoke to reduce their stress. They don’t make themselves a priority. And some feel they just don’t know where to start.
We start with knowing a woman’s numbers. Too often a women has her annual exam, but does not understand the proper range for important numbers. Her blood pressure should be less than 120/80. Her blood sugar should be less than 100. A healthy BMI ranges from 18.5 to 24.9. And total cholesterol should be less than 200.
Then we move to incorporating heart-healthy changes.
- Quit smoking. People talk about smoking and lung disease, but smoking is also a leading risk factor for heart disease because nicotine restricts blood vessels and puts pressure on the heart.
- Get moving. Adding physical activity to your life doesn’t require an expensive membership at a health club. Start with a 15-minute walk after dinner. Add 15 minutes in the morning before the kids get up. And set goals you can reach.
- Eat healthy. Focus on fruits and vegetables, whole grains and meals you prepare yourself.
- Monitor your weight. A 5-10% decrease in your weight can help lower blood pressure and blood sugar.
- Seek treatment for stress and depression.
- Limit alcohol to no more the one drink daily.
I worked with one woman in her 40s. She was overweight and had high blood sugar levels and a family history of diabetes and heart disease. She left my office in tears because she didn’t want the illnesses so many other women in her family had endured. But she was also determined. When she came back a few weeks later she had lost 12 pounds and her glucose and cholesterol levels were down – all without medication.
Of course there are medicines to control blood pressure, cholesterol and blood sugar. And many women need those medicines to control these heart disease risk factors. As women reach their 70s and 80s, many will develop heart disease that requires medical attention. I don’t argue with any of that. But I know, too, that there’s a place in every woman’s life for a healthy diet and physical activity and that prevention works.
Learn more about Wake Forest Baptist's cardiology services.
Susan Butler is a registered nurse and the Women’s Heart Health coordinator at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.