Women’s Health Month: Not all heart attacks look the same

An internist shares how she nearly dismissed her own symptoms

Dr. Sylvia Seamands was an internist for 30 years before retiring in 1995. When she started her career in 1966, at a time when few women were practicing medicine, Dr. Seamands cared for many female patients who felt more at ease discussing their medical issues with her. Treating cardiovascular disease (CVD) was also a common occurrence, as quite a few of her patients were elderly men and women.

With decades of practicing medicine, Dr. Seamands was well-versed in cardiovascular health. Yet, one evening in January 2012 when she was 70 years old, she disregarded a sharp, constant pain in her upper abdomen. And she brushed aside the shortness of breath she felt for the last month, attributing it to general weigh gain. Myocardial infarction wasn’t top of mind. Her symptoms weren’t typical of a heart attack. She had no chest or arm pain. Within an hour, she fell asleep and by the next morning, the pain was gone.

When she felt chest pain later that morning, she realized something wasn’t right and called a friend to take her to the emergency room. “I walked in and said, ‘I think I may be having a heart attack.’ They kind of looked at me cross-eyed,” she recalled. She had to convince them she was a doctor before they let her look at the EKG. “It was so obvious on the EKG that I was having an acute MI. I knew right away.” Shortly after, her chest pain subsided.

That day in 2012, Dr. Seamands experienced what’s commonly known as the widowmaker, a severe blockage of the left anterior descending artery. Even with years of treating CVD in her own patients and following research on hormonal effects on cardiovascular health, Dr. Seamands had shrugged off her discomfort as inconsequential.

Cardiovascular health in men and women

Until the mid-1980s, studies on CVD focused primarily on men. The assumption was heart attacks were a men’s issue, and symptom presentations published at the time lined up with that research.

Between mid-1980s to 1990s, research identified sex differences associated with acute myocardial infarction. Men described acute chest discomfort, upper body pain and shortness of breath. Women often had more subtle, atypical symptoms than men — and sometimes they had no symptoms at all.

Today, nearly 45% of women aged 20 and older are diagnosed with some form of CVD, and women account for half of the myocardial infarction deaths. While they can also experience acute chest pain, women complained mostly of back, neck, jaw and/or abdomen pain. They may feel fatigued, short of breath and nauseous. These symptoms were often overlooked, disregarded or categorized as anxiety or depression.

Help mitigate women’s risk of CVD

To get an overview of how CVD appears in women, take the online course “Insights into Addressing the Risks of Cardiovascular Health in Women.” Earn credits applicable to your field while discovering tools and methods that will help mitigate women’s risks of CVD and treat acute myocardial infarction.