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Women's heart health

Women who have heart disease

If you have heart disease, it is extremely important to take steps to control your condition. This section explains the symptoms of heart disease, tests you may need, warning signs of a heart attack and how to get emergency care.

Symptoms of heart disease

The first noticeable symptom of coronary heart disease may be angina, which is a periodic pain or discomfort in the chest that is caused by reduced blood flow to the heart. This pain usually occurs behind the breastbone and may travel down your left arm or up your neck or be a squeezing, pressing sensation that does not change with breathing. It is typically caused or worsened by exercise and eased by rest. The pain usually lasts two to five minutes.

Some women get a less typical angina. The chest pain may last longer, occur in a location other than behind the breastbone or not be worsened by physical activity and eased by rest. Some women have shortness of breath or indigestion.

If you have any of these symptoms, you should contact your doctor. With treatment, the outlook is good. Without treatment, however, the symptoms may recur and worsen and may even lead to a heart attack.

Diagnostic tests

In most cases, you will need to have some tests to find out for sure whether you have coronary heart disease, and also to find out how severe your condition is. If your doctor does not mention tests, be sure to ask him or her whether tests could be helpful. To get complete information about your condition, you may need more than one test. Most of them are done outside the body and are painless. The most common tests are:

  • An electrocardiogram, called an ECG or EKG, which makes a graph of the electrical activity of the heart as it beats. This test can show abnormal heartbeats, heart muscle damage, blood flow problems in the coronary arteries and heart enlargement.
  • A stress test, also called a treadmill test or exercise ECG, which records the heart's electrical activity during exercise, usually on a treadmill or exercise bicycle. Some older women may not be able to exercise due to arthritis or another condition. In such cases, a stress test can be done without exercise by using a medicine that increases blood flow to the heart muscle and shows if there are any problems in that flow.
  • Echocardiography which changes sound waves into pictures that show the heart's size, shape and movement. The sound waves also can be used to see how much blood is pumped out by the heart when it contracts.
  • A nuclear scan which shows the working of the heart muscle as blood flows through the heart. A small amount of radioactive material is injected into a vein, usually in the arm, and a camera records how much blood is taken up by the heart muscle.
  • Coronary angiography, which shows an x-ray of blood flow problems and blockages in the coronary arteries. A thin, flexible tube — or catheter — is threaded through an artery of an arm or leg up into the heart. A fluid is then injected into the tube, allowing the heart and blood vessels to be filmed as the heart pumps. The picture is called an angiogram or arteriogram.

Warning signs of a heart attack

If you have heart disease, you should know the symptoms of a heart attack so that you can get immediate medical help. Not all heart attacks begin with sudden, crushing chest pain, the way they are often shown in the movies and on TV. Instead, the most common warning signs are:

  • Pain or discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back
  • Pain that spreads from the chest to the arm, neck or jaw
  • Chest discomfort with sweating, shortness of breath, tiredness or upset stomach. These last three symptoms are particularly common in women

Heart attack symptoms may be severe from the start, or they may be mild at first then gradually worsen. Talk with your doctor about other symptoms of a heart attack and steps you should take.

Immediate self-help

If you experience heart attack symptoms and are taking nitroglycerin medication, take one nitroglycerin tablet as soon as you feel discomfort, a second tablet if the discomfort does not go away in five minutes and a third tablet after five more minutes if you are still experiencing symptoms.

In addition, you should chew one adult-strength (325 mg) uncoated aspirin, whether or not you have been prescribed nitroglycerin. If the symptoms stop, call your doctor immediately for further advice. If symptoms continue, dial 911.

Getting emergency care is a must

If the above medications do not relieve your discomfort within 15 minutes, get to the hospital fast. Be sure you know the phone number to call for emergency transportation. This is the best way to get to the hospital if you could be having a heart attack. In many areas, the emergency number will be 911; in other areas, it will be a seven-digit emergency number. (For more on what to do in case of a heart attack, see "Steps for Survival" below.)

Medical science now offers treatments that can stop heart attacks in their tracks if the treatments are given very quickly after the attack begins. These treatments include clot-dissolving drugs or coronary angioplasty (also called balloon angioplasty) to reopen the clogged blood vessel that has cut off the oxygen supply to the heart. These treatments save lives and reduce damage to the heart muscle — but only if they are given immediately.

New research shows that clot-dissolving medicine also can be used to treat a stroke, but once again, it must be used quickly to be effective. That means if you have stroke symptoms, you should get emergency help immediately. Warning signs for stroke include weakness or numbness in the face, hand, leg or foot; sudden blurred vision; difficulty speaking; and sudden dizziness or loss of coordination.

Steps for survival: What to do if you might be having a heart attack

Nobody plans to have a heart attack. But, just as many people have a plan to follow in case of fire, it is a good idea to have a plan to deal with a possible heart attack. Knowing what to do can save your life. Fill out this form and make several copies of it. Keep one copy near a phone at home, another at work and a third in your purse.

What to do ahead of time

  1. Discuss heart attack symptoms and what you plan to do in case of a heart attack with your doctor, family, coworkers and friends. Tell others how they can help you if you have symptoms. For example, they could help you with your medication or call 911 for you.
  2. Make a list of all your medications and how often you take each one. This list would be valuable information to the emergency department doctor or nurse.
  3. Know the location of the nearest 24-hour emergency department.
    • At home, the closest emergency department is ____________.
    • At work, the closest emergency department is _____________.

What to do if you have heart attack symptoms

  1. You may feel chest pain or discomfort, left arm pain, pain radiating to your neck or jaw, sweating, shortness of breath, upset stomach, or tiredness.
  2. Take medication right away.
    • Chew one adult-strength (325 mg) tablet of uncoated aspirin.
    • If you have been prescribed nitroglycerin, place one tablet under your tongue immediately. Take a second tablet if the discomfort does not go away in five minutes. Take a third tablet after five more minutes if the discomfort still hasn't gone away. If the symptoms do stop, call your doctor at this phone number:________________.
  3. Call for emergency transportation if symptoms continue for more than 15 minutes.
    • At home, the emergency phone number is ____________________.
    • At work, the emergency phone number is _____________________.

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