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June 2004 Issue
Women’s Heart Health: It’s Quite Different from Men’s
by Michael Fick
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Many women get their warning symptoms a month or two in advance. In decreasing order of occurrence, they are unusual fatigue (reported by 71%), sleep disturbance, shortness of breath, indigestion, anxiety, heart racing, arms weak/heavy (25%). During full-blown heart attacks, women’s reported symptoms in decreasing order were shortness of breath (58%), weakness, unusual fatigue, cold sweat, dizziness, nausea, arms weak/heavy (35%).

Notice the glaring lack of what many doctors consider the primary heart attack symptom: pain. Its lack leads many of them to rule out a heart attack. Even a man’s heart attack may not be unbearably painful at first, permitting its victim to delay seeking treatment for a few hours, while the heart suffers permanent damage often avoidable by prompt treatment. People have even driven themselves to ERs with ultimately fatal heart attacks an ambulance call could have averted.

Angina -- heart pain -- is the heart muscle’s response to oxygen deprivation due to diminished blood supply. Extreme oxygen deprivation, in which whole regions of heart muscle cells die for lack of oxygen, is a heart attack. Clearing the arterial blockage within a few hours of first symptoms can minimize permanent damage. That's why it is so vital to seek medical attention quickly if you feel the sort of pressing pain or heaviness described above; it’s angina 90% of the time. It will get worse and do more harm, and may be a man’s only advance warning of a potentially lethal condition.

Women aren’t even lucky enough to get pain before their heart attacks; their primary warning symptom is fatigue. Fatigue! It may as well be the rising sun for all the good that does … unless she and her doctor recognize unexplained fatigue for what it so often is: impaired blood delivery.

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