Heart disease is the number one cause of death for women in the United States and can affect women at any age. Despite the prevalence of heart disease in women, most don’t know how to recognize the symptoms — especially since they often present differently from men's. This was the case for Linda Kiewit who suffered a heart attack in January.
Linda is in her fifties and in overall good health, so she never suspected that a few days of some stubborn GI discomfort was the onset of a heart attack. She’s currently continuing treatment at the Froedtert and the Medical College of Wisconsin’s cardiac rehab center. Since her heart attack, Kiewit has made it her mission to share her story, hoping that fewer women will experience what she has.
"I never was guessing I would have a heart attack — I didn't believe it until they told me I was. And that was after a lot of things happening that were finally convincing me that was the case," says Kiewit.
Kiewit suffered a serious type of heart attack known as a "widowmaker." But her ordeal began as persistent indigestion that didn't initially alarm her. After a few days, Kiewit went to get checked out after her surgeon from a recent procedure urged her to, and the reality of the condition truly set in.
"Even waiting to be seen I was embarrassed," Kiewit admits. "I thought well this is ridiculous, they’re gonna take a look at me and say you have indigestion, give me a prescription level antacid and send me home. Well, that’s not what happened."
She says what happened at the hospital once the doctors realized Kiewit was experiencing a heart attack was "traumatizing."
"They initially took my blood pressure, they were concerned. They then immediately took an EKG, and it was so alarming they thought they had made a mistake, and they took another one right away," she recalls. "My husband later told me he was facing the EKG technician... He saw the EKG technician's face change and knew we were in trouble."
Dr. Stacy Gardiner is an assistant professor at Froedtert and the Medical College of Wisconsin, and also was one of the medical staff who treated Kiewit. She provides some clarification on early indicators of heart attack: "It's still important to remember that for both men and women, that chest pain, chest pressure, chest heaviness, however you want to describe it, discomfort in the chest is still the most common symptom for both men and women."
But women also have specific indicators separate from men, including indigestion, as Kiewit experienced, but also extreme exhaustion, nausea, and pain in other places like the jaw, back, shoulder, and neck.
Because the indicators of a heart attack are often different in women, women often ignore them or wait longer to get treatment. In addition to different symptoms, Gardiner notes that medical professionals may not take women's symptoms seriously initially, especially if they don't have many traditional risk factors.
"Historically most of what we understand about heart disease was done on studies that were mostly conducted on middle-aged men," she explains. "And so what we understand of heart disease, and how to treat heart disease is still not completely reflective of women."
One of the best things to do to stay on top of your heart health, especially for women, is to understand and minimize the risks associated with heart attacks and get preventative screenings. For both men and women, high-risk factors include smoking, diabetes, high blood pressure, obesity, and high cholesterol. For women specifically, risks include gestational diabetes, diabetes and pregnancy, hypertension and pregnancy, premature menopause, rheumatoid arthritis and lupus.
"It's better to be proactive than reactive, and so the best time to go to the doctors is actually when you're feeling well," says Gardiner.
Kiewit adds, "If I had known that gestational diabetes [is a risk factor] is a perfect example that I had never had that conversation before. So, that awareness alone can really help someone understand their potential risk."
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