In medical circles, they call it the Hollywood Heart Attack. You’ve seen it: grimace of agony, clutching of chest, sudden collapse, the whole purple-prose panoply.
For my husband, Harold Lear, a doctor who became a patient just that suddenly, it was the first stop in a five-year medical odyssey, one cardiac crisis after another, ending with the ultimate stop in 1978.
Through all the years that followed, it remained my assumption that the Hollywood Heart Attack was it: the paradigm, the norm, the way heart attacks are supposed to happen.
I was relieved of this assumption two years ago, when I had one of my own.
Mine went like this: altogether well one moment, vaguely unwell the next; fluttery sensation at the sternum, rising into the throat; mild chest pressure; then chills, sudden nausea, vomiting, some diarrhea. No high drama, just a mixed bag of somethings that added up to nothing you could name. Maybe flu, maybe a bad mussel, maybe too much wine, but the chest pressure caused me to say to my second husband, “Could this be a heart attack?” “Of course not,” he said. “It’s a stomach bug.”
Still, that pressure, slight but there, nagged at me. I called my doctor and reported my symptoms. The mention of diarrhea, almost never a presenting symptom in heart attacks, skewed the picture. He said, “It doesn’t sound like your heart. I can’t say a thousand percent that it’s not, but it doesn’t seem necessary to go racing to the emergency room with the way you feel now. Just see it through and come in for an EKG in the morning.”
The pressure eased. I slept, and woke the next morning feeling well. I went for the test mainly because I had said that I would, fully expecting to be told that I was healthy. First the EKG and then the echocardiogram told a different story: a substantial heart attack, “less than massive,” my doctor said, “but more than mild.” We were both stunned.
Suddenly I found myself living in a sequel: same hospital where Hal had worked and died, same coronary unit, same cardiologist, same everything; different husband wheeling me in my wheelchair through the corridors where I had wheeled Hal in his. Ghosts in every corner.
With a stent implanted in an occluded artery, I recovered fast and was cleared to leave in four days, but a bad hospital-acquired infection kept me there four weeks — time enough for a revelatory education about women and hearts.
Surprise No. 1: The biggest killer of American women is not breast cancer, as many people believe. It is heart disease. Should I have been surprised? Of course not. The American Heart Association keeps telling us about our hearts and we keep not listening, possibly because we are so fearful of cancer that we have no fear to spare, as we lie on our beds dutifully palpating ourselves for the lumps that we pray not to find.
Our hearts kill more of us than all kinds of cancer combined.
Surprise No. 2: I learn that Hal’s attack and mine are textbook illustrations of how vivid the gender differences can be. I learn that men more typically have “crushing” pain; women, nausea. That women are likelier to have early warning signs, such as unaccustomed fatigue or insomnia (unaccustomed: That’s the key word here). That we are likelier — this spooked me and kept me, for months, glued to calendars — to die within a year of a heart attack. That our symptoms can be so varied and nuanced that we feel no fear, seek no help, and possibly die — which may be why, although more men have heart attacks, a greater percentage of women die of them. (...)
Until shockingly recently — in fact, until this millennium — there was minimal research on women’s heart attacks because of widespread belief in the medical community that women did not have heart attacks. (When the American Heart Association introduced its Prudent Diet in the 1950s, it issued a pamphlet titled “The Way to a Man’s Heart.”
Research studies commonly used all-male subjects. Men with abnormal test results were treated far more aggressively than women with the same results. Women reporting the same symptoms as men were at least twice as likely to receive — no surprise here — a psychiatric diagnosis.
In a 1996 national survey of doctors, two-thirds were unaware of gender differences in symptoms and warning signs of heart attacks.
For my husband, Harold Lear, a doctor who became a patient just that suddenly, it was the first stop in a five-year medical odyssey, one cardiac crisis after another, ending with the ultimate stop in 1978.
Through all the years that followed, it remained my assumption that the Hollywood Heart Attack was it: the paradigm, the norm, the way heart attacks are supposed to happen.I was relieved of this assumption two years ago, when I had one of my own.
Mine went like this: altogether well one moment, vaguely unwell the next; fluttery sensation at the sternum, rising into the throat; mild chest pressure; then chills, sudden nausea, vomiting, some diarrhea. No high drama, just a mixed bag of somethings that added up to nothing you could name. Maybe flu, maybe a bad mussel, maybe too much wine, but the chest pressure caused me to say to my second husband, “Could this be a heart attack?” “Of course not,” he said. “It’s a stomach bug.”
Still, that pressure, slight but there, nagged at me. I called my doctor and reported my symptoms. The mention of diarrhea, almost never a presenting symptom in heart attacks, skewed the picture. He said, “It doesn’t sound like your heart. I can’t say a thousand percent that it’s not, but it doesn’t seem necessary to go racing to the emergency room with the way you feel now. Just see it through and come in for an EKG in the morning.”
The pressure eased. I slept, and woke the next morning feeling well. I went for the test mainly because I had said that I would, fully expecting to be told that I was healthy. First the EKG and then the echocardiogram told a different story: a substantial heart attack, “less than massive,” my doctor said, “but more than mild.” We were both stunned.
Suddenly I found myself living in a sequel: same hospital where Hal had worked and died, same coronary unit, same cardiologist, same everything; different husband wheeling me in my wheelchair through the corridors where I had wheeled Hal in his. Ghosts in every corner.
With a stent implanted in an occluded artery, I recovered fast and was cleared to leave in four days, but a bad hospital-acquired infection kept me there four weeks — time enough for a revelatory education about women and hearts.
Surprise No. 1: The biggest killer of American women is not breast cancer, as many people believe. It is heart disease. Should I have been surprised? Of course not. The American Heart Association keeps telling us about our hearts and we keep not listening, possibly because we are so fearful of cancer that we have no fear to spare, as we lie on our beds dutifully palpating ourselves for the lumps that we pray not to find.
Our hearts kill more of us than all kinds of cancer combined.
Surprise No. 2: I learn that Hal’s attack and mine are textbook illustrations of how vivid the gender differences can be. I learn that men more typically have “crushing” pain; women, nausea. That women are likelier to have early warning signs, such as unaccustomed fatigue or insomnia (unaccustomed: That’s the key word here). That we are likelier — this spooked me and kept me, for months, glued to calendars — to die within a year of a heart attack. That our symptoms can be so varied and nuanced that we feel no fear, seek no help, and possibly die — which may be why, although more men have heart attacks, a greater percentage of women die of them. (...)
Until shockingly recently — in fact, until this millennium — there was minimal research on women’s heart attacks because of widespread belief in the medical community that women did not have heart attacks. (When the American Heart Association introduced its Prudent Diet in the 1950s, it issued a pamphlet titled “The Way to a Man’s Heart.”
Research studies commonly used all-male subjects. Men with abnormal test results were treated far more aggressively than women with the same results. Women reporting the same symptoms as men were at least twice as likely to receive — no surprise here — a psychiatric diagnosis.
In a 1996 national survey of doctors, two-thirds were unaware of gender differences in symptoms and warning signs of heart attacks.
by Martha Weinman Lear, NY Times | Read more:
Image: Rachel Levit
