Sunday, February 16, 2020

Heart Attacks And Women

Come the start of 2020 I knew two things about women and heart attacks. I knew that women don't always feel chest pain. I also knew I was at high risk for a heart attack even at age 39. I am on blood pressure medication (Amlodipine 10 mcg) and cholesterol medication (10 mcg). I have been for years now. It became important a couple of weeks ago.

For a few weeks I did have chest pains off and on. They weren't real strong. But, they were there. Twice during that time I was at the doctor for something else. I mentioned the chest pains and the second time they did an EKG. The results were normal. But, I was told to keep an eye on it.

A few days after the EKG I called my doctor's emergency line at 3 o'clock in the morning. I was up to take my thyroid medication but had been fighting this strong pain in my left arm, up by my shoulder, all night. I had cold sweats and was nauseous as well. I wasn't sleeping. I described my history and symptoms to the doctor. I also said I can't think of anything I did that would have pulled it. She sent me to the ER.

I gave that doctor my list of medications and told him about the high blood pressure and cholesterol. They did bloodwork to check my cholesterol levels and a new EKG. By the time I was getting tested my arm and shoulder had been in serious pain for 24 hours. My cholesterol was impressively good (his words) and my EKG was normal. In all likelihood, I pulled a muscle. The chest pains were likely from my panic attack.

That's why I didn't take the original chest pains too seriously. I get them with panic attacks and it was a very stressful time. I needed ibuprofen but, I can't have that because I am on blood pressure medication. So Tylenol it was! A lot of people, even doctors, forget that you can't take ibuprofen with blood pressure medication. There are a lot of medications, especially cold medications, that can't be taken with blood pressure medications. Know what you can't have and speak up!

I was lucky. But, a lot of women feel belly pain, nausea, cold sweats, and/or pain in their left arm.  They don't feel chest pains. Zach witnessed me getting both EKGs. He saw me sharing the medication list verbally with the doctor even after the admission nurse had put it in my chart. He had to be woken up to come to the hospital with us.

It may have not been a heart attack. But, it had a lot of the same symptoms. To be fair, a lot of those symptoms are also symptoms of panic attacks. It's not over-reacting to get checked out for these symptoms. Some day saying "it's probably nothing. I just want to be safe" tp the doctor might be what saves your life.

In red are quotes from other websites. Links provided. 
  1. Chest pain or discomfort. Chest pain is the most common heart attack symptom, but some women may experience it differently than men. It may feel like a squeezing or fullness, and the pain can be anywhere in the chest, not just on the left side. It's usually "truly uncomfortable" during a heart attack, says cardiologist Rita Redberg, MD, director of Women’s Cardiovascular Services at the University of California, San Francisco. "It feels like a vise being tightened."
  2. Pain in your arm(s), back, neck, or jaw. This type of pain is more common in women than in men. It may confuse women who expect their pain to be focused on their chest and left arm, not their back or jaw. The pain can be gradual or sudden, and it may wax and wane before becoming intense. If you're asleep, it may wake you up. You should report any "not typical or unexplained" symptoms in any part of your body above your waist to your doctor or other health care provider, says cardiologist C. Noel Bairey Merz, MD, director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles.
  3. Stomach pain. Sometimes people mistake stomach pain that signals a heart attack with heartburn, the flu, or a stomach ulcer. Other times, women experience severe abdominal pressure that feels like an elephant sitting on your stomach, says cardiologist Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Medical Center in New York.
  4. Shortness of breath, nausea, or lightheadedness. If you're having trouble breathing for no apparent reason, you could be having a heart attack, especially if you're also having one or more other symptoms. "It can feel like you have run a marathon, but you didn't make a move," Goldberg says.
  5. Sweating. Breaking out in a nervous, cold sweat is common among women who are having a heart attack. It will feel more like stress-related sweating than perspiration from exercising or spending time outside in the heat. "Get it checked out" if you don't typically sweat like that and there is no other reason for it, such as heat or hot flashes, Bairey Merz says.
  6. Fatigue. Some women who have heart attacks feel extremely tired, even if they've been sitting still for a while or haven't moved much. "Patients often complain of a tiredness in the chest," Goldberg says. "They say that they can't do simple activities, like walk to the bathroom."

Not everyone gets all of those symptoms. If you have chest discomfort, especially if you also have one or more of the other signs, call 911 immediately.
https://www.webmd.com/heart-disease/features/womens-heart-attack-symptoms#1

If you have any of these signs, call 9-1-1 and get to a hospital right away.
  1. Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.
  2. Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
  3. Shortness of breath with or without chest discomfort.
  4. Other signs such as breaking out in a cold sweat, nausea or lightheadedness.
  5. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.
https://www.heart.org/en/health-topics/heart-attack/warning-signs-of-a-heart-attack/heart-attack-symptoms-in-women 

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Washington Post article

https://www.washingtonpost.com/health/women-can-have-heart-attacks-without-chest-pain-that-leads-to-dangerous-delays/2020/02/14/f061c85e-4db6-11ea-9b5c-eac5b16dafaa_story.html

American Heart Association

https://www.goredforwomen.org/en/about-go-red-for-women


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