Ellen Abramson’s father and both her grandfathers had heart disease. And that’s why she assumed she was safe. Although Abramson experienced chronic heartburn, crushing fatigue and shortness of breath for months, “I really didn’t understand. I never once thought about my heart. I had assumed it was a man’s disease,” she says. That was three years ago when, at age 51, Abramson had a heart attack.
Although she was an avid exerciser for many years and carefully watched her weight, Abramson’s family history and the fact that she was a closet smoker increased her risk for heart disease, the leading cause of death for American women.
Raising awareness is an ongoing challenge. “Women older than 50 who had heard about women’s heart disease through the media were more likely to take action to prevent their own heart disease. Despite this progress, however, one out of two women remain unaware of the risk,” says Dr. Andrea Moyer, a cardiologist with Cardiac Specialists of St. Luke’s.
“Women need to know what their individual risk for heart disease is because in the United States, approximately one out of six women will die from it,” Moyer says. “One of the proposed explanations why women are more likely to die from heart attacks compared to men is because they wait too long to seek medical attention.”
Not only did Abramson shrug off her troubling symptoms, assuming her busy schedule was sapping her energy, she also drove to the hospital when she realized she was in trouble, a decision she now recognizes as a mistake. “We’re still seeing a lot of women with what we call ‘late presentations,’ ” explains Dr. Mark Friedman, a cardiologist with SSM Heart Institute. “They’re finally getting to the cardiologist or to the emergency room later than they should have. And the result is that women have a big problem—what we call ‘silent heart attack.’ ”
Friedman is referring to instances in which patients ignore symptoms to the point where eventual medical evaluation uncovers prior heart damage, sometimes hours or days after the heart attack occurs. Besides late presentation, however, women often exhibit vague symptoms that do not fit the classic heart attack image: Fatigue, shortness of breath, indigestion- like discomfort, nausea, jaw pain, shoulder or arm pain, as well as chest pressure or pain—sometimes persisting for weeks or even months—are among the warning signs that should be evaluated.
“In one study of women coming in with acute heart attack, the most common symptoms were shortness of breath, weakness and fatigue,” Friedman says. “Chest pain was absent in 43 percent.”
Given these statistics, prevention has become the focus for most physicians and patient advocacy groups. “Lifestyle matters. You cannot change your genetic makeup, but hopefully you can choose to eat the right food, exercise regularly, not smoke, maintain an ideal weight as closely as possible and take your medication,” Moyer says. “With lifestyle modification alone, you can reduce your risk of heart attacks, strokes and heart-related death by approximately 40 percent.”
Abramson recalls that the talk of lifestyle modification began even before she was out of intensive care after having a stent placed in her blocked artery. “The cardiologist wanted to talk to me about olive oil, and I was really shocked,” she says. “Here I had just been through cardiac arrest, and he wanted to talk about olive oil.” Consuming a couple teaspoons of olive oil every day is just one of the many changes Abramson has made to her diet. She now eats whole foods instead of processed items, consuming the vegetables, fruits, lean proteins and whole grains found in the Mediterranean diet.
Abramson is back to exercising on a regular basis— swimming, jogging, walking and using her elliptical trainer. She pays attention to her body, seeking medical attention if she feels anything is amiss and following her physicians’ orders for consistent follow-up care. She knows and understands her blood pressure and cholesterol levels.
“I used to be most concerned about looking good in my jeans, but now I know it’s really about being alive to wear my jeans,” she says. “I could have missed so much in the last three years. I’m a very lucky woman.”