Dr C: “Heart attacks aren’t a ‘male’ problem”
The misleading perception that heart disease is a male issue means that thousands of women die each year, and the pandemic has seen fewer seek help. Dr C wants to raise awareness
Have you ever seen a female character have a heart attack on TV? It’s always men clutching their chests and collapsing. In our culture, we think of heart attacks as a male problem, but heart disease is the biggest killer of UK women.
KNOW THE SIGNS
In one study, only one in eight women reported chest pain during a heart attack, which they felt as pressure, aching or tightness, not pain. Women are also more often misdiagnosed, again partly because of this cultural idea that only men have heart attacks, but also because their heart problems can be harder to spot. They often get swollen ankles, unexplained fatigue or shortness of breath, which could have many causes.
PAIN CAN MOVE
There are several signs not to ignore or write off as stress or heartburn. The most important is chest pain that also makes you feel unwell, so sick, dizzy or sweaty. The pain may not even be in your chest – it may be in your tummy or back and can spread to your arm, neck or jaw. If you get that kind of pain with those feelings of being unwell, call 999 as it may be a heart attack. You should tell your GP if you have swollen ankles coupled with shortness of breath, or unexplained fatigue, when you
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feel exhausted even though nothing has changed to make you feel that way.
TUNE IN TO TUMMY PAIN
Persistent stomach pain is another potential first sign of heart problems. In terms of an irregular heartbeat, if you become a bit obsessed with your heartbeat you’ll notice that it changes all the time. It’s when you’re doing nothing and you suddenly notice your heart beating in a funny way that you need to call 111 or your GP for advice. Women very often suffer with deep fatigue and disturbed sleep as much as a month or two before a heart attack, so don’t ignore it if your sleep goes haywire for no reason. Tell your doctor so they can figure out what’s going on. It may not be heart problems, but it will be caused by something.
HORMONES MATTER
If you have diabetes, high blood pressure, if you’re overweight with a large waist, if you smoke, and if you have high cholesterol, you’re at greater risk of heart problems. After menopause, cholesterol and triglycerides (a type of fat found in your blood) can change, because your body produces less oestrogen. This increases the risk of the coronary arteries narrowing, so also ups your risk of developing coronary heart disease. It’s important to go into menopause at a healthy weight, too. If you have HRT, recent evidence shows it doesn’t increase your risk of dying from a heart attack. Some research shows it is even beneficial as it improves cholesterol. There isn’t a heart health risk with the contraceptive pill. If your doctor was concerned, they would change the type of pill you’re on, but all women who take the pill are monitored.
THINK ABOUT FAMILY
Your heart isn’t like your liver, so it doesn’t regenerate. If a heart attack “kills” a bit of your heart muscle, it won’t repair itself. That’s why it’s important to make lifestyle choices to help your heart. The single most important thing you can do is to not smoke. Aside from that, eat well, avoid excessive alcohol, exercise regularly, avoid too much fat or salt, eat lots of colourful veggies and know your family history. If your dad has high cholesterol, your grandmother had heart failure and your grandfather had angina, you may have high cholesterol, for example. One in 250 people have genetically high cholesterol, so they could be eating salad and running on the treadmill every day and it still wouldn’t come down. You wouldn’t know you had high blood pressure or cholesterol because there are no obvious signs or symptoms, so if you’ve reached your thirties and
haven’t had your blood pressure or cholesterol checked, ask your doctor. The most common solution is statins because they are safe and beneficial. They can have side effects, usually muscle aches and pains, but there are lots of different statins, so we can try you on different ones. If you don’t get on with any of them, there are other options too, so ask your GP.
DON’T STAY SILENT
People are still having as many heart attacks as ever, pandemic or not, so if you notice any of the signs I’ve described, don’t think it’s a male problem, or decide not to waste precious NHS time – talk to your doctor.