I was in good health… then I had a heart attack
For middle-aged women, heart disease can be confused for something else – as Esther Stanhope discovered. Maria Lally reports
When she hurried through Gatwick airport in June 2017, Esther Stanhope felt clammy and breathless. “I was about to catch a flight to Amsterdam where I was speaking at a conference. It was a warm day and I was pulling my suitcase along, when momentarily I couldn’t quite catch my breath. But I was rushing and stressed and put it down to that,” she remembers.
The 47-year-old mother of two from London, who runs her own business creating leadership programmes for large companies, barely gave it a second thought and when she mentioned it to a friend, they said it was probably a minor panic attack. A few weeks later Esther flew to New York to speak at a conference, and also to meet up with one of her brothers and sister-in-law.
“In New York, I was quickly walking up the road to grab a taxi, when I felt slightly breathless again. I also felt a little faint and dizzy. But things really came to a head the following day when my sister-in-law and I booked in for a fitness class.
“After a few minutes of burpees and weights, I started to feel sick. I went outside for some fresh air but I couldn’t seem to get enough into my lungs. My brother suggested going to the doctor immediately, but even though I had travel insurance I couldn’t be bothered to spend two days in an American hospital. I just wanted to get home, so the next day I flew back to the UK and rang my GP who suggested I come in.” Esther’s GP
ran through some questions: did she have any pain in her left arm? No, just a slight numbness, she replied. Did it feel like there was an elephant sitting on her chest? No, just a kitten. And finally, did she have a family history of heart disease? It was then that the penny dropped: “I told my GP that yes, my father, a university lecturer, had died of a heart attack when he was just 50, and I was five years old,” says Esther.
Her doctor sent her straight to A&E, where tests revealed her breathlessness at Gatwick, feeling faint and her turn in the exercise class in New York, was the result of a heart attack.
“I was stunned,” says Esther. “I’d even walked to A&E. Growing up, my four brothers and I were aware of our father dying of a heart attack. But Dad had experienced that classic male heart attack that you see in films: despite being a fit man, he jogged up a flight of stairs one day, had a heart attack, fell unconscious, and sadly died.
“I’ve since learnt that female heart attacks can often take a different, subtler course. The other thing that stunned me was that all of my brothers, who have always been more worried about their hearts than me, were absolutely fine.
“I’ve always looked after myself: I go to the gym, I’ve never been overweight, I don’t drink too much, I eat healthily. The only thing I’m guilty of is rushing around too much for work, but ironically in the year before my heart attack I’d scaled things back.
“And while I was aware of my family history, I honestly thought it was my brothers who needed to worry. Like most fortysomething women, I was more concerned about finding a lump in my breast. We’re not told to worry about heart attacks.”
But this needs to change. A study published this week found that deaths from heart disease among under 75s are rising for the first time in 50 years. Our increasingly sedentary lifestyles and soaring rates of diabetes and obesity are thought to be partly behind the rise. But the study – from the British Heart Foundation – found that millions of people are also living with undiagnosed conditions, like high blood pressure and high cholesterol, that increase their risk of a heart attack.
“These factors, combined with a growing population, mean that increasing numbers of people are now dying from heart and circulatory diseases before their 75th, or even 65th, birthdays for the first time in more than 50 years,” the report said.
The study also questions the long-held belief that heart disease is a man’s disease. “Women are most definitely at risk and unfortunately when women do have heart attacks, we know from research that their symptoms aren’t taken as seriously by Women’s symptoms can differ from classic chest pain (but this can also be true for men). We also know women tend to wait longer before discussing symptoms with their GP, or calling 999, which could be due to differences in pain threshold, not wanting to cause a fuss, or simply not being aware they can be at risk of a heart attack. Signs and symptoms of a heart attack in women include:
Chest pain or discomfort – the most recognised symptom of a heart attack, though not always present.
Pain or numbness radiating to both arms, neck, jaw, stomach and back. You may experience pain in just one or all of these places; for some people the pain is severe but for others just uncomfortable.
A feeling of indigestion or reflux type pain – this is often ignored in the hope it will pass.
Feeling sick, sweaty, breathless or lightheaded with associated chest pain or discomfort.
A general feeling of being unwell or lethargic can also be an indicator of a heart attack when accompanied by chest pain or discomfort. hospital staff,” says Ashleigh Li, a senior cardiac nurse. “This is especially true of younger women, because of the perception that heart attacks are a male thing.”
Heart disease kills more than twice as many women as breast cancer every year, and 68,000 women in the UK are admitted to hospital following a heart attack each year.
Li says that while younger women may be at risk due to lifestyle factors, or genetic conditions, older women who have gone through the menopause are at equal risk to men: “The female hormone oestrogen protects the heart because it slows down the rate at which fatty deposits build up in the arteries. However, levels of oestrogen decline during the menopause so a post-menopausal woman’s risk of heart disease is the same as a man.”
A recent American study by Dr Sameer Arora at the University of North Carolina found that young women are less likely to receive cardiovascular treatments like beta blockers and angiographies.
“Cardiac disease is sometimes considered an old man’s disease, but the trajectory of heart attacks among young people is going the wrong way. It’s actually going up for women,” said Dr Arora. “Also, the presentation of heart attack is different in men and women. Women are more likely to present with atypical symptoms compared to men, and their heart attack is more likely to be missed.”
Luckily, that wasn’t the case for Esther, who had a stent fitted and made a full recovery. “I spent a week in hospital with this overwhelming fear of dying and leaving my sevenand 11-year-old children behind, like my father had.
“The words ‘heart attack’ need to be rebranded, so more women are aware of what they can be like,” she says.
“Unlike my father, I had intermittent feelings of breathlessness and restlessness over the course of six weeks, which I put down to being a busy, stressed, working mother of two.
“I’ve been mindful of my heart from a very young age, but even I didn’t know what I was experiencing was a heart attack. As a young woman, I didn’t look like a heart attack victim, but I was.”
MALE VS FEMALE HEART ATTACKS BY VANESSA WHITE, A SENIOR CARDIAC NURSE
‘I was more concerned about finding a lump in my breast’