Heart disease kills a woman every minute. Four times as many women succumb to heart attacks, strokes or other related events as do to cancer. It is the nation’s most prevalent disease and women largely overlook it. While the bad news is that heart disease may very well affect someone you know, the good news is that it is not only treatable, but it’s also largely preventable.

The month of May marks the American Heart Association’s Go Red for Women campaign, dedicated to educating women about the signs and atypical symptoms of heart disease women experience that can often be misdiagnosed.

“Like in men, heredity is very important, but to a major degree, heart disease is a lifestyle disease,” says Dr. Gary Badzinski with OSU Medical Center.

“It is contributed to by improper diet, lack of exercise, smoking, high blood pressure and high cholesterol.”

While it is important to understand that women can experience the classic symptoms of a heart attack – tightness in the chest, discomfort or numbness down the arm – issues often manifest differently in women.

“One of the things I always stress is that women can have the classic symptoms of a heart attack,” says Dr. Mary Ann Bauman, with Integris Health in Oklahoma City.

“However, women can have more subtle symptoms – pain between the shoulder blade and back. Decrease in exercise tolerance, nausea and overwhelming fatigue can also be signs of a heart attack.”

“…We fall into the trap of thinking our normal is normal and you don’t think of these things being symptoms of something abnormal.”

According to Bauman, it’s more difficult to diagnose heart disease in women because the signs can mimic stress and anxiety.

“Strong family history, obesity, hypertension, hyperlipidemia, diabetes mellitus, sedentary lifestyle and smoking are the most common heart disease causes,” says Dr. Jamal Hyder, with St. John Internal Medicine Specialty Group.

“A physician usually evaluates a patient for heart disease with a thorough medical history and risk identification for the development of coronary artery disease.”

Tests include stress tests, EKGs and a carotid ultrasound. The important thing, experts say, is to recognize the atypical signs sooner and act on them instead of making excuses.

“Women tend to ignore their symptoms of angina more so than men,” Hyder explains. “They tend to have atypical presentations like shortness of breath, discomfort in the neck and jaw or may have a gassy feeling. Since they do not seek medical attention earlier, the chances of a fatal coronary event are greater for women.”

“If you’re over 40 and you begin to feel these atypical symptoms, you need to start asking yourself, ‘Do I have a blockage?’” says Dr. Wayne Leimbach, a cardiologist with the Oklahoma Heart Institute.

Campaigns such as the American Heart Association’s Go Red for Women are targeted at educating women on recognizing and taking seriously any abnormal symptoms they may experience.

If classic or atypical signs of a heart attack are occurring, Hyder recommends taking aspirin and getting to the doctor’s office immediately.
“If angina is suspected, it should not be ignored. The earlier you get to the hospital, the sooner treatment can be started quickly without causing any damage to the heart.”

“Time loss is brain loss,” adds Bauman. “Getting to the hospital sooner saves lives.”

According to Leimbach, prevention requires taking your health into your own hands and knowing your risk factors.

“Prevention starts early,” he says. “Blockages can start as early as the teen years. If you have a family history of heart disease, you can get a carotid ultrasound. It’s very low-risk and runs about $40. EKGs allow us to see if there’s any damage to the heart and can serve as a good baseline for any future treatment. Of course, those at the highest risk are those with high blood pressure, diabetes and smokers.”

Reports have suggested that quitting smoking can decrease a person’s chance of chance of heart disease by 50 percent. Diet also plays a large part in prevention. A low sodium diet – the AMA recommends the DASH Diet – can aid in lowering blood pressure.

“Americans eat enormous amounts of salt,” Leimbach says. “Start trying a low-salt diet. Forget egg yolks, too. They have almost 500 grams of cholesterol. That’s the equivalent of eight to 10 Big Macs’ worth of cholesterol. Cheddar cheese and ice cream are probably the biggest offenders in the American diet and are huge culprits of saturated fat.”

Cutting out the worst diet offenders and striving for 30 minutes of exercise each day can help boost cardio function. These are just a few easily implemented changes that can have a big impact on your health.

“There are online tools that you can use to assess your risk of heart disease,” says Badzinksi. “A search engine will allow you to find these by entering ‘cardiovascular health risk calculator.’ The AHA now recognizes women who exhibit greater than 10 percent risk of heart disease over 10 years as high risk.”

“When you educate the women, you educate the whole family unit,” Bauman believes. “Women need to understand the need for changes.

With heart disease and things like childhood obesity on the rise, we may be seeing the first generation of children that might not live as long as the previous generation.”

Bauman advises that when it comes down to starting a routine for a healthier life, the best thing to do is get your body moving.
“If you move, it will lead to changes in all aspects of your health.”

Stress Triggers

“By appearance, I’m probably one of the healthiest people you’ll meet,” says Leah Ashlock, owner of Carbon Pilates in Tulsa.

“I run like crazy, I like to work – I own the largest Pilates facilities in this part of the country. I’ve trademarked my own Pilates technique. I have 11 percent body fat. I just don’t look like the traditional person who suffers from heart disease.”

But heart disease is exactly what made this 39-year-old mother of three slow down and take inventory of her life after suffering from a mini-stroke.

Ashlock, a self-proclaimed workaholic who frequently burns the midnight oil, has high blood pressure – a condition shared by her mother – that is triggered by stress.

“I like to work, often to the detriment of my body,” she says. “I knew that I had high blood pressure, but that was always when my body is in stress – either from pregnancy or undergoing a surgery.

“I started having headaches and spotted vision. You would think with my knowledge of the human body, I would think something was wrong. I didn’t. There were always excuses – if I was lightheaded it was because I hadn’t eaten, if my vision was blurry, it was because I needed an adjustment. I just wasn’t paying attention to what my body was trying to tell me.”

While at a friend’s house, Ashlock began to feel ill with a headache and was seeing spots. Chalking it up to being tired from working non-stop, she continued about her day, even stopping at Target to pick up a magazine.

“Women tend to ignore their symptoms more so than men.”

“The last thing I remember is seeing a sign for 101st Street. I was later found eight miles from there. I somewhat remember waking up not being able to lift my head up. I have an emergency button in my car that called my parents. They couldn’t understand what I was saying. I had thick tongue. When the medics arrived my blood pressure was 168/122. I had a severe mini-stroke.”

Doctors put Ashlock on blood pressure medication but she started to pass out from it since her blood pressure was stress-related.

“It was so frustrating at the time. The medication switching was horrible. I’m more of an all-natural kind of person. It’s taken me a long time to come out with this. Because of my career, there was a lot of shame and embarrassment.”

Today, Ashlock has learned to recognize the signs of when she’s becoming too stressed and she has taught herself boundaries.

“When I became involved with the American Heart Association and the Go Red for Women campaign, I wanted to share with other women that you don’t have to be obese to be affected by heart disease. You can be the picture of health. Women have this mentality that we have to take care of everyone else first and take care of ourselves last. We have to be selfish – we have got to put ourselves first.”

Since her stroke, Ashlock has found ways to reduce her stress, has hired a personal assistant and has modified her work schedule to bring work home only a couple of nights a week. When she feels her stress levels rise, she takes breaks by walking around Brookside or shopping. Ashlock also has modified her diet – which was already healthy – to be even more heart-conscious.

“There are so many women out there that are killing themselves slowly due to stress,” says Ashlock. “You don’t have to be stereotypical to have heart disease. All women should be aware of the signs and symptoms. Don’t ignore what your body is trying to tell you.”

A Unique Heart

A dental hygienist, mother of four and a hardcore Jenks football fan, Robin Burch never really let anything slow her down, but she couldn’t force her body to keep going sometimes.

With a double chamber right ventricle, a condition diagnosed in only 100 others in the U.S., fatigue and an accelerated heart rate were frequent occurrences.

“I never knew what it was until last year,” Burch says. “I never really noticed how it affected me until I went to my doctor for my once-a-year check-up. My heart had never sounded good – doctors would often bring others in to listen because the murmur sounded so bad.”

It was at this visit that the murmur had gotten to a point that could no longer be ignored. At almost 50, it was time for Burch to make an appointment with a cardiologist to find out exactly what her heart was trying tell her.

“I had always been healthy – I never let my heart condition prevent me from doing anything. I would run and work out, and try to be active,” she says. “But my heart rate would increase really fast and I would be short of breath, even after months of working out. I would always hear that what I was experiencing was abnormal, but I think that sometimes we fall into the trap of thinking our normal is normal and you don’t think of these things being symptoms of something abnormal.”

When Burch met with a cardiologist, he ran several tests, including a stress test and heart catheterization that lasted nearly three hours. Burch’s heart problems put her into a rare class of individuals: Her right ventricle produced two different pressures.

“To put it in perspective, it would be like putting a catheter into a balloon and receiving two different pressures.”

The double chamber right ventricle is so rare that there are no specialists in Oklahoma who handle these cases.

“It was either going to be the Mayo or Cleveland Clinic,” Burch says. “My husband saw an ad in the Wall Street Journal for the Cleveland Clinic’s top rated heart program for the past 15 years.”

After much discussion and planning around her favorite high school’s football season, Burch and her husband made an appointment with a surgeon who had performed 20 procedures on similar cases. The fact that Cleveland is home to the Rock ‘n Roll Hall of Fame was the final selling point for Burch.

In May 2010, she met with the specialist at Cleveland Clinic who ran several tests. Burch’s numbers were on the edge for those who should consider surgery.

“I’m an all or nothing kind of person. We where there, I wanted to go for it,” she says. “When the doctor walked out from the surgery, he told my husband that there was going to be a huge difference. The part that was closing in was about the size of a dime. He opened it up to be the size of a half dollar. They also discovered two holes in the atrium that could’ve led to a stroke.”

Burch checked in to the hospital on a Tuesday and left the following Monday, feeling like a new woman. She has since completed the Tulsa Run 5k race and has been skiing twice.

“It’s been such a huge change! I can work longer, I run longer. I’m so glad I had the surgery.”

Today, Burch wants to get the message out that your “normal” may not be so normal after all.

“If you have a question, go to the doctor and find out. Don’t ignore it. For years, I would be out of breath and take asthma medication. I struggled for years, and it was because of my heart – I just didn’t know it. Trust your instincts and get yourself checked out.”



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