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Are You at Risk for a Heart Attack?

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Communicating with Those Who Can Help

The most frustrating situation is when a woman thinks she's having a heart attack but can't convince her caregivers. When 26-year-old Belinda Jenkins awoke one morning with severe indigestion and shortness of breath, followed by vomiting, she called 911 and said that she thought she was having a heart attack. "The dispatcher kept asking me, 'Are you sure?,'" she recalls. Once in the ER, she waited nearly 40 minutes before any cardiac testing was done. "The nurses and the doctors kept asking me if I'd been using drugs, saying that an admission would help me get medical attention more quickly," says Jenkins. At last, she convinced a doctor to give her an EKG, which revealed that she had indeed suffered a heart attack.

Why aren't doctors making the connection between suspicious symptoms and a significant cardiac event? Studies show that gender does influence diagnosis, even in seasoned physicians. In a 2006 study, Dr. Mosca presented 800 doctors with patient profiles in which the heart-risk levels were identical, but the genders differed. "Even when a woman's risk was the same as a man's, doctors were more likely to classify her case as significantly lower risk," explains Dr. Mosca. Other research reveals that fewer than one in five practicing physicians knows that more women than men die of heart disease each year.

Women not only experience a distinct kind of heart-attack pain, they also use different words to describe their situation. When they have chest pain, for instance, men use dramatic, attention-grabbing words like "crushing" or "viselike"; women typically complain of "tiredness" in their chest, says Nieca Goldberg, MD, of the Women's Heart Program at New York University and author of Dr. Nieca Goldberg's Complete Guide to Women's Health. (In her study, McSweeney found that women also labeled their discomfort as heaviness or burning.) Women can help their cause by being as direct and detailed as possible about what they're feeling, says McSweeney. "Don't just mention that you feel tired. Say, 'I can't walk to the mailbox.' Your doctor will be better able to evaluate you as a potential heart-attack patient."

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