Last summer, Joan O’Malley, 85, of Houston, noticed that her ankles were more swollen than usual. And although she was short of breath, she ignored it. Finally, in the fall, she scheduled an appointment with her cardiologist.
“My doctor thought I was at risk of a heart attack.” O’Malley says. After all, O’Malley also has diabetes, high blood pressure, and is overweight—all heart attack risk factors. “And everyone in my mother’s family died of heart disease,” she says.
O’Malley is one of the lucky women who got treatment—catheterizations clearing two arteries of plaque–and avoided a heart attack. Like O’Malley, many women have atypical heart attack symptoms that they often ignore.
“Less than 40 percent of women have chest pain and about 50 percent have shortness of breath,” says her doctor, Karla Kurrelmeyer, MD, a cardiologist with Houston Methodist DeBakey Heart & Vascular Center in Houston and associate professor of Medicine at Weill-Cornell Medical College in New York City.
Below are ways to help you avoid a close call like O’Malley’s or an actual heart attack.
Bone up on atypical symptoms.
Although women may have typical heart attack symptoms such as chest pain, they often have symptoms such as fatigue, insomnia, shortness of breath, shoulder pain, or sudden sweats, says Kurrelmeyer.
According to a 2012 study of data about more than one million male and female patients at the Watson Clinic and Lakeland Regional Medical Center in Lakeland, Florida, almost 40 percent of women had no chest pain with an heart attack, which can lead to a delayed diagnosis and less assertive treatment.
Because women may expect to have classic symptoms, they wind up at the hospital on average about an hour later than men, which also means the outcome is likely to be worse, says Kurrelmeyer.
“Only about one percent of women have classic symptoms,” says Kurrelmeyer. “Most women have atypical symptoms or just don’t feel well. So you can’t ignore those symptoms.”
Know your risk factors.
Age, family history, smoking, high blood pressure and/or cholesterol, diabetes, being overweight and inactive are heart attack risk factors for both men and women. But women also have risk factors that men don’t share, says Kurrelmeyer: “If women have high blood pressure during pregnancy or if they have an inflammatory condition such as lupus or rheumatoid arthritis, they are more at risk. Inflammation makes the plaque in arteries more unstable so that it may break off in pieces, activating the clotting system.” Clots can then block the arteries, which can lead to a heart attack.
Cut your vulnerability.
Walking 150 minutes a week, eating fruits, vegetables, foods high in fiber like brown rice, and low-fat proteins like fish can go a long way toward preventing a heart attack. Quitting smoking and treating high blood pressure and diabetes are key as well
“If you address these modifiable risk factors, you can delay a heart attack for at least ten years,” says Kurrelmeyer. “More women die of heart attacks than men because they lack that awareness.”
O’Malley is using her new knowledge. “I don’t get a thrill out of exercise,” she says. “But I now go to the gym every day to use the treadmill or stationary bike for 15 to 20 minutes, and I’m going to do more.” And although O’Malley loves potato chips, she’s avoiding them: “I know they make plaque. I know I have to eat well.”