Why many women fail to recognize that they're having a heart attack

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Comedian Rosie O’Donnell’s announcement that she failed to realize that she’d suffered a heart attack last week has drawn attention to the challenge of identifying heart attacks in women.

Most women and even some doctors don’t realize that heart attack symptoms can be very different for women than those experienced by men.

"The symptoms that we have told people to pay attention to - things like chest pain – are not the typical symptoms in women," says cardiologist Noel Bairey Merz, director of the Barbra Streisand Women’s Heart Center at the Cedar Sinai Heart Institute.

She says fewer than half of all women who have heart attacks feel the chest pain or pressure typical of male heart attacks. More commonly, she says, female heart attacks are accompanied by unexplainable fatigue; nausea or stomach pain that mimics heart burn; shortness of breath; and a cold sweat or clamminess.

But because most heart attack research is focused on males, women’s symptoms have been less publicized and are considered “atypical," says Bairey Merz. This remains true even though 267,000 women die each year from heart attacks — six times more than the number of women who die annually from breast cancer.

"We think this is a significant contributor to the increased death rate," says Merz. "When women can’t recognize the signs and symptoms, they’re less likely to seek health care assistance.”

That’s in part what happened to O’Donnell, who reported in her blog this week that while she did have some chest pain and other symptoms, she nevertheless failed to call 9-1-1. Instead, she wrote that she took Bayer aspirin and waited to call her doctor. It wasn’t until she made a visit to her physician the next day that she learned she had suffered a heart attack.

Bairey Merz says O’Donnell’s reaction is unfortunately typical of many U.S. women. And she says more sex-specific heart attack research and more education of health care providers and the public, is key to reducing female heart attack death rates.

Dr. Bairey Merz Tips[1]

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