Heart Disease Women and Women

Take Heed and Make Time to Take Care of Your Heart

Lisa Walsh, a national sales manager for WHSV-TV, was between Zoom meetings at home on Feb. 12, 2021, when she began to feel anxious.

The feeling didn’t make sense to her at the time, since she wasn’t nervous or stressed about anything in particular that day.

“Then my arms started to hurt, but I kept working,” says Walsh, 52, of Harrisonburg. “I felt tired, so I cut out of a meeting early and thought I’d take a 10-minute nap, which isn’t something I normally do. Suddenly I felt sweaty and dizzy. I looked at my face in the mirror—it was white, and I had no life in me.”

Walsh, who was home alone, called 911. Emergency crews arrived rapidly and realized she was having a heart attack. They rushed her to Sentara RMH Medical Center while communicating with the waiting medical team about her condition.

“This was not the typical heart attack you read about,” says Walsh. “My heart didn’t hurt. I wasn’t grabbing my chest.”

Heart Attack Symptoms More Subtle in Women

Walsh’s heart attack symptoms are more common for women than men, explains Tanya Tajouri, MD, a cardiologist specializing in women’s heart health at Sentara RMH.

“The textbook symptoms—such as crushing chest pain, like an elephant is sitting on your chest—aren’t necessarily what women experience,” explains Dr. Tajouri, who joined Sentara in 2018. “Women are more likely to feel tired, dizzy, lightheaded and nauseous, or have indigestion and trouble sleeping.”

Often, women experience three or more of these symptoms leading up to a heart attack, according to Dr. Tajouri. Sometimes these symptoms can linger for days to months before a woman experiences a heart attack.

“Some of the symptoms can be subtle or silent, so they tend to get brushed aside,” Dr. Tajouri adds. “We need to empower women to know the risk factors and recognize the symptoms—especially as they get older.”

Heart disease is the leading cause of death for both men and women. In fact, more women die from heart disease than from all cancers combined, Dr. Tajouri notes.

While women and men face similar risk factors, heart disease generally becomes more concerning 7-10 years later for women than men—particularly after they enter menopause.

“Menopause and changing hormone levels trigger weight gain,” Dr. Tajouri explains. “Women can be especially at risk if they have a larger waist or midsection. Also, around menopause, blood pressure often goes up, and cholesterol can change with a drop in estrogen.”

Heart Attack Treatment and Aftermath

Genetic high cholesterol played a significant role in Walsh’s heart attack. Discovering that her right coronary artery was fully blocked, doctors placed a stent in the artery to open and support it.

The established goal for opening a blocked artery once the patient shows up in the emergency room—known as door-toballoon time—is 90 minutes, as set by the American College of Cardiology. At Sentara RMH, impressively, the average door-to-balloon time is just 52 minutes.

“The whole treatment team worked swiftly and explained every step,” Walsh recalls. “They coordinated my care from the moment I got in the ambulance. Within a couple of hours of my heart attack at home, I was already recovering in my hospital room.”

Doctors told Walsh that a few months after she recovered from her stent procedure, she would need open-heart surgery to unblock the left anterior descending artery (LAD), which typically supplies blood to more than half of the heart. A blockage in the beginning of the LAD is often called the “widowmaker” because it stops blood flow to the left side of the heart. Without oxygenated blood, the heart muscle dies within minutes.

As Walsh researched where to have her open-heart surgery, she looked at many options throughout the region. She wanted to be sure that her surgeon was highly skilled and experienced, and also to feel confident that the chest scar would be as inconspicuous as possible.

When she met with Sentara RMH cardiothoracic surgeon Yuriy Zhukov, MD, she knew she had found the right surgeon and the right hospital. The fact that she found what she needed so close to home was even more reassuring.

“I was impressed with Dr. Zhukov’s encouraging, approachable manner and his impeccable credentials,” says Walsh, whose open-heart surgery took place in April. “Dr. Zhukov promised me he’d do everything he could to make the scar as small as possible, and that is exactly what he did.”

Walsh also appreciated how kind and thorough Dr. Zhukov and the entire care team were during her postsurgical recovery in the hospital. When she got home, Walsh relied on her son, Ryan, 21, and dear friends and family for support during her early recovery. She is also grateful for the support and encouragement of her colleagues at WHSV.

“Dr. Zhukov promised me he’d do everything he could to make the scar as small as possible, and that is exactly what he did.”

Heart-Healthy Changes and Self-Care

Dr. Tajouri monitored Walsh’s health and recovery following her surgery, and Walsh’s providers continue to keep tabs on her cholesterol levels. She now focuses on getting more exercise and eating even healthier than before.

Heart Attack Symptoms in Women Heart disease risk factors for men and women:

As with men, the most common heart attack symptom in women is chest pain or discomfort. But women are more likely than men to experience some other common symptoms, including:

• Arm pain

• Back pain

• Cold sweats

• Difficulty sleeping

• Dizziness/lightheadedness

• Feeling anxious

• Jaw pain

• Nausea/vomiting/indigestion

• Shortness of breath

Call 911 immediately if you are concerned that you may be experiencing a heart attack. Do not drive yourself to the hospital.

• Diabetes

• Eating diets high in processed foods, sodium, saturated fat, sugar and cholesterol

• Family history of early heart disease

• High blood pressure

• High body mass index (BMI): A BMI of 25-30 is considered overweight. A BMI over 30 is considered obese.

• High cholesterol

• Sedentary lifestyle: Doctors recommend 20-30 minutes of exercise a day, most days. This exercise doesn’t have to be strenuous—you just need to get your heart rate up. Pick something that you enjoy, so you will stick to it.

• Smoking

Risk factors for women:

For women, diabetes, mental stress, depression, obesity and smoking are higher risk factors than for men.

Women are also affected by:

• Menopause

• Polycystic ovarian syndrome

• Pregnancy complications such as high blood pressure, pre-eclampsia, gestational diabetes, preterm delivery and having a baby weighing in the lowest 10th percentile

• The age they started menstruating, if before 10 years old or after 17 years

Nine out of 10 women have at least one risk factor for heart disease or stroke. Even if a risk factor is under control with medication, it is still considered a risk factor. The good news is that 80% of heart disease and strokes can be prevented through lifestyle changes.

Dr. Tajouri sees many women who are so busy managing work and home life, they can’t find time to concentrate on their own health.

“As women, we are so focused on taking care of everyone else and making sure everything is in order, we often let our own health care fall to the bottom of the list,” Dr. Tajouri says. “Women also tend to minimize symptoms. In fact, for a lot of women, the first sign of heart disease is a heart attack.”

Had she not been home alone, Walsh says she likely would have ignored her symptoms and not called 911, to avoid bothering her family and friends.

“I know if someone had been with me at home, I would have said, ‘I’m OK. I’ll just go lay down,’” she says. “If I had done that, I likely would have died.”

Treatments for heart attacks are most effective when given within one hour of the onset of a heart attack, according to Dr. Tajouri. Walsh’s prompt treatment minimized the damage to her heart muscle and saved her life.

After a heart attack, women are also less likely than men to follow up with cardiac rehab, possibly due to family obligations. For that reason, Dr. Tajouri advises providers and family members to make sure follow-up care is a priority.

Take Heed of Symptoms and See Your Doctor

Dr. Tajouri urges women of all ages to pay attention to changes in their health. Women may be self-conscious about seeing a doctor and gathering their weight, blood pressure, cholesterol and other important information. However, checking these vital numbers regularly is essential to working toward better heart health.

“Please set any hesitancy aside and know that your health is important to you and your family,” Dr. Tajouri says. “The good news is that 80% of heart disease and strokes can be prevented through lifestyle changes alone.”

Walsh is grateful for Dr. Tajouri’s care and advice, and appreciates how positive, reassuring and sympathetic she has been.

“When you notice changes in your health and energy, it’s worth going to the doctor,” Walsh says. “If I had gone for regular checkups, I would have known more about my high cholesterol and been put on medication to control it. I also have very minimal heart damage because I got to the hospital right away during my heart attack. Be sure to listen to your body and get help when you need it.”

Heart disease and COVID-19

Patients with underlying heart disease experience an increased risk of complications with COVID-19. Even after they have recovered from the virus, they can still experience palpitations, increased heart rate, shortness of breath with activity and atypical chest pain, according to Dr. Tajouri.