Putting It All Together; New Medical Research Shows How Different from Men Women Really Are. Take Heart Disease: Female Symptoms Are More Subtle and Often Get Overlooked. What to Watch for, What to Do

By Kalb, Claudia; Springen, Karen et al. | Newsweek, May 10, 2004 | Go to article overview

Putting It All Together; New Medical Research Shows How Different from Men Women Really Are. Take Heart Disease: Female Symptoms Are More Subtle and Often Get Overlooked. What to Watch for, What to Do


Kalb, Claudia, Springen, Karen, Raymond, Joan, Newsweek


Byline: Claudia Kalb and Karen Springen, With Joan Raymond

Like most women, Kathy Cunningham, 49, a wife, mother and senior VP at a Chicago bank, was well acquainted with the emotional chambers in her heart. Joy, sadness, love. But Cunningham never thought much about her heart as a muscular pump: the size of a fist, weighing less than a can of soda, beating 100,000 times a day. And she certainly didn't think it was vulnerable to disease. The picture of fitness--a nonsmoker, slim, good blood pressure and cholesterol--Cunningham was most concerned about her reproductive health, and she was religious about getting mammograms and Pap smears. But two years ago she was rushed to the ER, sweating, short of breath, in pain. A test revealed a 90 percent blockage in a coronary artery. The diagnosis: heart attack. "We all focus on breast cancer," says Cunningham. "I had no idea women had heart disease."

Every year a quarter of a million women die of heart disease--more than the total number killed by breast cancer, diabetes and Alzheimer's combined--making it America's No. 1 killer of women, as well as men. Women who have heart attacks are treated less aggressively, fare worse and die at higher rates than men. And yet the vast majority of women worry more about their husband's dropping dead than they do about the danger lurking in their own blood vessels. A new survey by the American Heart Association found that only 13 percent of women say they consider heart disease their greatest health risk, and barely more than one third have discussed the condition with their doctor.

As the population ages and cardiovascular hazards like diabetes continue to rise, women are more at risk than ever. In response, public-health officials have launched nationwide awareness campaigns to sound the alarm about this "silent killer." Scientists are busy unraveling the unique and sometimes mysterious ways in which coronary disease develops in a woman's body. And doctors in the know are educating their peers, many of whom still operate under the bias that men have a monopoly on matters of the heart. All the attention is starting to pay off, says cardiologist Bernadine Healy, the first female director of the National Institutes of Health, who helped put women and heart disease on the map, "but there's no doubt we have a way to go."

From an anatomical point of view, a woman's heart is no different from a man's: four chambers and several ounces of muscle tissue. But the symptoms of heart disease in men and women can appear as different as, well, the colors blue and pink. Men typically experience difficulty breathing and chest pain--still considered the hallmark symptom of a heart attack--which can travel up to the jaw and down the arm. Many women, however, feel no chest sensation at all, and their symptoms are often subtle: an unyielding fatigue, shortness of breath, nausea or indigestion, back or abdominal pain, or just an odd, unwell feeling. Compounding all that is the fact that too many women downplay their own health for the sake of their families, says Dr. Vera Rigolin, of Chicago's Northwestern Memorial Hospital: "They tend to ignore the symptoms because they have to take care of everybody else."

Carolyn O'Donnell, 62, remembers feeling "like a wuss" when her husband made her go to the ER. A runner and golfer, O'Donnell is normally an upbeat, high-energy grandmother of four. But on April Fool's Day 2002, she felt a little bit off. She was tired, she had a headache and she noticed an odd sensation near her heart. It was mild, though, no radiating pain, nothing more than "a mouse on my chest," she says, not that elephant everybody worries about. Her self-diagnosis: probably just the flu. But O'Donnell's husband--luckily, a physician--insisted she be checked out. Doctors discovered a piece of plaque clogging a crucial artery and a heart working at half its normal capacity. The "flu" was a full-blown heart attack. …

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