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Women Are More at Risk to Misinterpret the Symptoms of a Heart Attack

Photo courtesy of Kim Pommerer

Photo courtesy of Kim Pommerer

It’s not uncommon to experience ebbing pain or muscle soreness, especially if you’re busy and active. But for nurse Kimberlee Pommerer, these pains were symptoms of a minor heart attack at age 49. “I had back pain — pain that would come and go. [The discomfort] was between my shoulder blades in my back,” she explains. Chalking it up to a past injury, Pommerer pushed through the pain. As it persisted, she went to the hospital: “One day, the pain in my back was so bad, I couldn’t sit up straight.”

Though she had an irregular EKG and was instructed to follow-up with a cardiologist, Pommerer wasn’t short of breath and was alert and talking. As an experienced nurse, she knew the typical symptoms of a heart attack, noting: “I wasn’t short of breath, no chest or arm pain or numbness.” Moreover, Pommerer led a busy life: two jobs, exercise, time spent traveling with her family for her son’s sporting events (“I was really busy”). Consulting a cardiac specialist for her back pain seemed unnecessary at the time. 

It wasn’t until a friend and fellow nurse referred her to cardiologist Leslie Poor MD, FACC, FAHA of Bryn Mawr Hospital, part of Main Line Health’s Lankenau Heart Institute. Dr. Poor identified her symptoms as a heart issue. “I was suggesting [that] we do a less aggressive assessment, [but] she said I needed a cardiac [catheterization],” Pommerer explains, “She was insistent I get admitted right from her office to the hospital”. The interventional cardiologist performed the cardiac catheterization that day.

Pommerer did, in fact, have a heart attack. At the cardiac catheterization lab, doctors found a tightly blocked left anterior descending coronary artery, which was opened with a stent. Left ventricle function soon returned to normal.

Now healthy and taking medication for her heart, Pommerer is doing significantly better. “I visit my cardiologist every 3 to 6 months, and I can honestly say I’m feeling great,” she says.

However, her situation is not uncommon. Dr. Poor explains, “not all patients experience this classic symptoms of a heart attack. In particular, women may not experience the classic chest pain of a heart attack.” These less common symptoms may include nausea, jaw or back discomfort, shortness of breath, extreme fatigue or sweating, usually lasting longer than a few minutes.

Looking back, Pommerer can see some of these very symptoms. Prior to the heart attack, Pommerer, who is an avid walker, says, “I felt tired and my legs felt weak. Not short of breath, I just was tired. I forced myself to rest and restarted the walk home.” Her symptoms also included her aforementioned back pain.

This symptom misinterpretation occurs frequently with women. According to Poor, “The Yale University School of Public Health published data this past year, 2015, that demonstrated women’s symptoms of a heart attack varied substantially, and women commonly attributed their symptoms to noncardiac causes such as indigestion, anxiety or fatigue.” Moreover, she continues, “Women weighted competing and conflicting priorities before they decided to seek acute care and delayed in seeking the medical care they needed to treat the heart attack.” This misattribution could be deadly: “Delay in diagnosis and treatment of a heart attack can lead to heart muscle damage, heart failure and possibly death.”

For many, this hits close to home. Most women can relate to hectic schedules, fatigue and fleeting pain, but that’s why heart disease awareness for women is even more important. But luckily, it appears awareness and treatment is improving.

The day after we spoke with Dr. Poor, she forwarded us exciting news: the first Scientific Statement from the American Heart Association on Acute Myocardial Infarction in Women was published in its journal Circulation on January 25th. Dr. Poor says, according to the statement, “this past decade, for the first time, [there are] marked reductions in cardiovascular mortality in women.” The hope is that with continued public education and more patients like Pommerer sharing their stories, women will be better equipped to identify cardiac health risks and take preventative steps before heart disease strikes.

For more information about women’s heart disease and cardiac health risks, visit Lankenau Heart Institute here.