The first fact to come to grips with is that heart disease is a woman's disease. One out of 10 American women age 45 to 64 years has some form of heart disease. After age 65, one in four women have heart disease. It is one of the leading causes of death for women, just as it is for men.

The major risk factors for heart disease are very much the same for women as they are for men as well. Cigarette smoking, high blood pressure, high blood cholesterol, overweight, and physical inactivity all pave the way. Other risk factors, such as diabetes, also are conditions you may be able to control. Even just one risk factor will raise your chances of having heart-related problems.

One thing the sexes do not share about heart disease and heart attack are the symptoms. A recent study has found that women start experiencing warning signs of an impending heart attack a month or more before the event. These symptoms aren't the dramatic bouts of chest pain or arm numbness that men typically report. They are milder, more common sensations that show up all at once or suddenly increase in severity.

A Difference in Perception

The most common sign that something was amiss, experienced by three-fourths of the heart attack survivors in the study, was unusual fatigue. About half started having unexplained sleep disturbances and shortness of breath. Only a third reported chest discomfort, and they described it as pressure, aching, or tightness, not as pain.

Many women ignore these seemingly vague and undramatic symptoms. They and their physicians sometimes shrug the symptoms off as signs of aging. "Women need to explain to their doctor how these symptoms are impacting their daily life," says chief researcher Dr. Jean C. McSweeney. "They should specifically say what they can't do." It's one thing to say you're fatigued, quite another to say you were so tired you couldn't finish making the bed. A detailed description helps the physician judge how severe the situation is.

When the women's heart attacks arrived, the symptoms continued to be different and less dramatic than men's. Without the chest-clutching pain, many of the women underestimated their symptoms' severity. In general, women wait about a half-hour longer than men to go to the emergency room when they first suffer heart attack symptoms. With more than 250,000 people a year dying within one hour of the onset of cardiac symptoms and before they reach the hospital, women need to recognize their symptoms and take action. 

WARNINGS OF HEART ATTACK (Beginning a month or more before the event.)

• Unusual fatigue.

• Sleep disturbance.

• Shortness of breath.

• Indigestion.

• Anxiety.

• Chest discomfort.

DURING HEART ATTACK

• Shortness of breath.

• Weakness.

• Unusual fatigue.

• Cold sweat.

• Dizziness.

• Chest discomfort.

Smartmove: If you start experiencing symptoms on the list of warning signs, make some descriptive notes about the severity and duration of the symptoms. Your doctor may be able to make a more precise diagnosis using this information.

Content Provided by Parrish Medical Center and Vim abd Vigor, www.parrishmed.com