Be Still My Beating Heart: The Truth About Heart Attacks, The Media, and Women

This Post Was Written By Victoria Palmatier.

Don Vito Corleone (Marlon Brando) dying of a heart attack while spending time with his grandson in “The Godfather”

There’s a lot of white noise out there about heart attacks. Everyone knows that classic scene in the movies–usually at the peak of chaos –where the man dramatically clutches his chest, looks at the camera with wide eyes, and falls over as the screen goes dark, before he wakes up in a hospital bed. Perhaps most famously portrayed in The Godfather, Don Vito Corleone (Marlon Brando) died while playing with his grandson in the tomato garden. Off the screen in real life, actual heart attacks vary drastically. Sure, some have the same heart attack Jack Nicholson did in Something’s Gotta Give – where he recovers with Diane Keaton’s nurturing hand – but that’s hardly the case. All this Hollywood stereotype is good for is dramatic effect. Heart attacks come in all shapes and sizes, despite what the media portrays. One participant in a study about the cause of delay for seeking medical help in heart attacks says,

 

“Well, I saw Superman, you know, when he clutched his chest, went to his arm, and then he died…Do you remember that, when Superman’s adopted father on earth died of a heart attack?”

 Quite often the signs are much more subtle – such as shortness of breath, dizziness, back pain – but can be deadly if help isn’t sought out as quickly as possible. Additionally, men and women may experience different symptoms. Quite often women experiencing heart attacks ignore the pain, convincing themselves they have the flu or acid reflux, because they assume a heart attack can only feel like an elephant sitting across the chest.

There’s a difference in male and female heart attacks

For some reason, our society tends to perceive heart attacks as a “man’s disease,” reserving cancer for women. Any person with even a basic medical knowledge could tell you this is ridiculous. According to the American Heart Association (AHA), heart disease is the number one killer of women in the United States. Heart disease in women is a real threat–just as cancer in men–and should not be taken lightly. The AHA says to watch out for these symptoms

  1. Uncomfortable pressure, squeezing, fullness or pain in center of chest that lasts for a few minutes, or goes away and comes back
  2. Pain or discomfort in one or both arms, back, neck, jaw, or stomach. Some women describe the upper back pain like someone is squeezing them in a bear hug, or gently tying a rope around them.
  3. Shortness of breath (with or without chest discomfort)
  4. Other symptoms something is wrong, such as cold sweats, nausea, or lightheadedness
  5. Although both men and women are likely to experience the chest pain, women are much more likely to experience the other symptoms as well
  6. Unusual fatigue, sleep disturbances, indigestion, or anxiety

Heart Attack Symptoms

 

“Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure,” said Nieca Goldberg, M.D., medical director for the Joan H. Tisch Center for Women’s Health at NYU’s Langone Medical Center.

A twelve-year study, completed in 2009, revealed that only 53% of women would actually call 9-1-1 if they thought they were having a heart attack. Many studies have shown acute coronary syndromes must be addressed within an hour of onset, and any further delay has a drastic impact on morality. Over the past several decades, despite efforts to increase public awareness, delay in seeking treatment still poses a severe problem, especially in women and minority groups.

Why the Delay?

There have been over one hundred studies over the past thirty years, and most of them focused on the relationship between socioeconomic factors and delay in seeking help. According to a scientific statement by the AHA Council on Cardiovascular Nursing and Stroke, these factors affect patient delay in seeking help:

  • Older age
  • Female gender
  • Lower education level
  • Racial minority
  • Lower socioeconomic status
  • Medical History of: angina, diabetes, hypertension, heart failure, smoking, hyperlipidemia
  • Living alone or being alone at time of attack
  • Consultation with a family member
  • Decision to: self-diagnose, wait for symptoms to disappear on their own
  • Fear of: concerning or inconveniencing others, consequences of seeking help, embarrassment by seeking help.
  • Onset of attack during sleep

Many women I see take an aspirin if they think they are having a heart attack and never call 9-1-1,” Goldberg said later in her interview. “But if they think about taking an aspirin for their heart attack, they should also call 9-1-1.”

In the study mentioned earlier, over half of the women interviewed said common barriers to prevention included family responsibilities and confusion by the media, and nearly all of them stated there needs to be more access to healthy foods, public recreation facilities, and nutrition information in restaurants. Additionally, pre-disposed mistrust in medical institutions, previous medical care experiences, access to necessary services, and effectiveness of communication add challenges to a patient’s decision to seek help.

What should I do if I think I’m having one?

As with all health crises, you should just call 9-1-1. Just do it.

How can I prevent them? How can I recover from one?


Hollywood loves the drama of a beloved character clutching their chest and falling to the ground, but few scenes show the nitty-gritty of the long, hard recovery process, let alone the emotional/physical toll it takes on the victim useand their loved ones. Heart treatment – both before and after a heart attack – can be determined by an echo test
(echocardiography), or an ultrasound of the heart. If you have a heart murmur, unexplained chest pains, rheumatic fever, congenital heart defects, or a heart attack in the past, it might be wise to consult with your primary care provider about getting one.

Regardless of your gender, every member of every family can work as a team to prevent cardiac arrest and reduce the risk of heart disease. Together, you can implement good habits – such as consistent exercise and walks, healthy diets, and regular visits to your primary care provider for blood pressure, cholesterol, and glucose checks – and stay alert to signals your body might be giving you. Go Red for Women has a great start to creating an action plan to keep your heart healthy.

Do you want to take steps, but don’t know where to begin? Atkinson Family Practice’s nutritionist, Michele La Rock, would be ecstatic if you came in for a nutrition consult, and let her help you get back on your feet.  If you smoke tobacco, quitting will decrease your risk for heart disease by over 50%. One of our providers, Doctor Wendy Chabot, has a smoking cessation program and she would love to work with you.