Young Women Miss Heart Attack Symptoms

According to a study presented at the American Heart Association’s 8th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, young women are unable to recognize warning signs of impending heart attacks. The study findings suggest most women below the age of 55 fail to take note of calls from their hearts.

The study was conducted by Judith Lichtman and colleagues at the Yale School of Medicine in New Haven, Connecticut. 24 women, all below 55 years of age and who had heart attacks were covered under the study. The women were admitted to one of two Connecticut hospitals.

The researchers questioned the women about their symptoms prior to the heart attack to ascertain if the patients recognized or understood that they were suffering a heart attack and were at risk for heart disease.

They found that nearly 90% of the women showed typical heart attack symptoms including chest pain. On a scale of one to 10 (10 being the most painful) the average rating of chest pain was found to be 7.4.

“This means that they were experiencing significant chest pain,” said Lichtman, an Assistant Professor in the Department of Epidemiology and Public Health at the Yale School of Medicine. The most surprising finding for the researchers was that only 42%, roughly 4 in 10, of the women who were hospitalized believed there was some problem with their heart. “Many of them told us that they thought they had indigestion or heartburn,” Lichtman said.

The patients also reported other less typical heart attack symptoms such as pain in the jaw or shoulder, sweating, nausea, shortness of breath, indigestion or heartburn and weakness or fatigue. The study revealed that only 50% of the women went to an emergency room within an hour of symptoms beginning to show.

“When we asked the women why they delayed going to the hospital, half of those who waited more than an hour said they were afraid their symptoms weren’t real; about 42% attributed their symptoms to something else; about 17% said they were embarrassed by their symptoms; and 8% admitted that they feared the symptoms or experienced denial that it could be heart disease,” Lichtman said.

Additionally the researchers found that nearly 88% of the women had a family history of heart disease. While 71% of the women said they were in fair or poor health, not even 50% considered themselves at any risk for heart disease.

Women below 55 years account for less than 5% of all hospitalized heart patients. However the high number of heart attacks each year in the US makes even this small percentage a sizeable figure. Nearly 40,000 young women are hospitalized each year with heart disease with around 16,000 deaths. According to the study authors, this makes it one of the leading causes of death in this particular group.

“The number of young women who die from coronary heart disease each year is roughly comparable to the number of women who die of breast cancer in this age group,” said Lichtman. “Studies have shown that young women with heart disease are twice as likely to die in the hospital as similarly aged men. While these statistics are startling, relatively little is known about the clinical presentation, care or outcomes of young women with heart disease.”

In the researchers’ opinion, doctors might not be linking symptoms in many young women to heart disease. The researchers found that 38% women consulted their physician when they first noticed symptoms; however only 56% of these women were advised by their doctors that their symptoms were heart-related.

“It seems that many young women are not connecting their symptoms with heart disease, even more are simply unaware of the possibility that they are at risk for a heart attack,” Lichtman said. “We have to get the messages across to young women that they are at risk for a heart attack, they might experience not only typical but also atypical symptoms, and they need to be aware of their own risk factors, including family history. Prevention and modification of risk factors is important for young women.”

“To avoid possible permanent damage to the heart muscle, young women, like their older counterparts, must seek prompt care if they have symptoms. They also must be persistent with their health providers – especially if they have risk factors, including high blood pressure, high cholesterol, obesity, smoking, inactivity, diabetes and family history,” Lichtman said.

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