MEDICAL SURFARI; HEART OF A WOMAN

Nowadays, a person experiencing a heart attack has a better chance than ever to survive and make a good recovery. According to the American Heart Association, from 1980 to 1990, the death rate for myocardial infarctions declined more than 32%. Survival and recovery depend upon recognition of the signs of a heart attack and immediately seeking medical help. Of course, good long-term recovery often involves full cooperation of the patient including changes in lifestyle.

Heart attack is the single largest killer of American women. For a period of time, women are well protected from heart disease by the estrogen hormone that their body produces. However, with menopause estrogen levels drop and women develop heart disease almost as commonly as men. One in every nine women age 45 to 64 and one in every three women over 65 will develop heart disease. Black women are at a significantly higher risk than white women for heart disease at all ages.

There is a great deal of denial when it comes to heart attacks. And since the stereotypical victim of a heart attack is often a middle-age man with an impatient "type A" personality and a high stress job, women have been conditioned to think of heart disease as a male problem. Nothing could be further from the truth, as heart attacks occur almost equally among men and women over age 65.

Women's heart attack symptoms are sometimes different than those of men. Men often have sudden pressure, fullness, or squeezing pain in the center of the chest that lasts more than a few minutes or that may go away and come back again. It is not unusual for this pain to radiate from the center of the chest to the shoulders, arm, neck or jaw. Chest discomfort with light-headedness, fainting, sweating, nausea or shortness of breath is also not unusual.

Women may have many of the above symptoms as well, although their symptoms are sometimes more subtle. Chronic breathlessness or waking up at night having difficulty catching one's breath, as well as overwhelming, unusual chronic fatigue may be associated with heart disease. Dizziness or unexplained light-headedness and even black-outs, as well as swelling of the ankles or lower legs may be subtle symptoms of heart disease. Fluttering or rapid heartbeats and even gastric upset or nausea may be warning signs.

Leading healthy lifestyles reduces the risk of heart disease in both men and women. Maintaining a regular schedule of preventative medical examinations and taking note of individual risk factors for heart disease may also reduce your chances of a heart attack. The best gift you can give your heart is to stop smoking. Nicotine increases your heart rate, constricts blood vessels, and the carbon monoxide from smoking reduces the amount of oxygen available for your heart. Healthy living includes regular exercise, staying trim, maintaining a well-balanced diet, or sticking to your prescribed diet, handling stress well and maintaining good control of your blood pressure and blood cholesterol.

World Wide Web Resources

Heart Information Network

http://www.heartinfo.com/hinf_hp.html

This educational Web site provides a wide range of information and services to heart patients and others interested in learning about lowering risk factors for heart disease. It also includes articles related to women and heart disease.

American Heart Association

http://www.amhrt.org/Heart_and_Stroke_A_Z_Guide/womens.html

This site provides you with an A to Z guide filled with facts and statistics on heart disease.

LUHS - Health Topics Index: Cardiovascualar Health

http://www.luhs.org/frames/health/card/index.htm

This Web site from Loyola University Health System includes Health Topics and is intended as a symptom-oriented consumer health guide. The information contains a broad discussion on conditions, symptoms and treatments on women and heart disease, as well as a variety of other health issues.

Women's Health Alliance

http://www.womenshealthalliance.com/

This site includes a Health Topics Library and weekly Health Links to issues affecting women's health provided by the Women's Health Alliance Editorial Advisory Board.

Dr. Scott Gibbs is a neurosurgeon and editor-in-chief of Mosby's Medical Sufari. You may e-mail questions to him at drgibbs@semissourian.com or write in care of the Southeast Missourian, P.O. Box 699, Cape Girardeau, Mo., 63701.