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Matters of the Heart

Men and women have different experiences with heart attack

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Matters of the Heart

Men and women experience heart attacks in unique ways. The stories of two heart attack survivors demonstrate just how different the experience can be and why paying attention to what our bodies are telling us is so important.

Just like fingerprints and snowflakes, no two hearts are alike. And men and women experience matters of the heart—physically, at least—much differently.

A heart attack happens when blood flow to the heart muscle becomes blocked, restricting oxygen. Depending on how long blood supply is cut off, heart damage can occur, from mild to severe, and can sometimes be fatal.

Men and women experience heart attacks in unique ways. The stories of two heart attack survivors demonstrate just how different the experience can be and why paying attention to what our bodies are telling us is so important.

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Marjorie Sanders—“Don’t ignore subtle signs.”

After a successful career as a legal assistant, in 2001 Marjorie Sanders retired to the Okanagan in the BC interior with her husband. The 73-year-old grandmother of four walks everywhere and doesn’t smoke. Although she had developed slightly high blood pressure a few years ago, she considered herself to be the picture of health until the fall of 2018.

Sanders rolled over in bed one night and noticed “a bit of a pop” on the left side of her chest. But it was over in a flash, she had no pain, and by morning she didn’t give it another thought. A few weeks later, she started feeling unwell in a subtle way: she was unusually tired on her regular walks, but upon resting at home she would feel better.

Then her teeth and jaw started to hurt. A Google search led her to believe it was probably reflux, so she carried on with acetaminophen. The discomfort persisted. She went to her doctor, who noticed nothing wrong.

That aching jaw should have been a red flag: it’s a telltale sign of heart attack in women. About a week later, still taking pain relievers, Sanders went to bed, only to experience strange sensations in her chest.

“There was never any pain,” Sanders recalls. “It was like a rumble or spasms. I would sit up and it would go away. Lying down seemed to make it worse. It wasn’t painful, but it was something you couldn’t ignore or put up with. I said to my husband, ‘I think we should go to the hospital.’”

Many women experience a heart attack but, even upon going to hospital, don’t get a diagnosis or explanation of cause, says cardiologist Dr. Tara Sedlak. This is called a “silent heart attack.”

“This is because women are more likely to experience heart attacks from less well-understood conditions such as vasospasm, and these do not show up on a standard angiogram,” Sedlak says. “These undiagnosed patients are at risk for future events and often have high levels of anxiety over not receiving a diagnosis for this heart condition.”

There, she learned she was having a heart attack. An ultrasound the next day showed that one of her arteries was 95 percent blocked. “I couldn’t believe it,” she says. “We were stunned. On TV, you see people clenching their chest. My arms weren’t sore, and I had no nausea or vomiting. I don’t have any history of it in my family.”

Surgeons placed a stent in her heart, and Sanders recovered fully. She takes blood pressure medication, checks in with her cardiologist regularly, and is back to feeling great.

Looking back on her experience now, Sanders says it’s important to deal with high blood pressure, especially understanding possible reasons behind it. Women know their bodies; Sanders encourages them to pay attention to anything that just doesn’t feel right. Jaw pain is an often-overlooked symptom in females.

“My symptoms were vague; I felt just not well,” she says. “It wasn’t grand and dramatic like you see on TV. Don’t ignore subtle signs.”

Risk factors

  • For men and women, risk factors include smoking, unhealthy weight, high blood pressure, diabetes, stress, and lack of exercise. Age and family history also contribute to greater chances of heart attack.
  • Excessive use of alcohol and recreational drugs such as cannabis can increase the risk of heart disease.
  • Women have other unique factors. Menopause, hormone replacement therapy, and pre-eclampsia during pregnancy all affect women’s hearts.

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John McLellan—“Stress can affect anybody.”

In May 2017, Jon McLellan ran a half marathon. A month later, at age 41, he had a heart attack.

The founder of Gillespie’s Fine Spirits in Squamish, BC, McLellan recalls the weekend it happened. His daughter was not yet two years old, and his business wasn’t much older.

After pulling an all-nighter to get ready to travel to Vancouver to sell products at a farmers’ market there, the self-employed husband and dad spent the day working, then returned to Squamish and went straight to a family gathering. Later that evening, he was loading heavy items into his car when he felt a wave of nausea.

“I was overheating, just instantly sweating,” McLellan says. “I was kind of dizzy and remember thinking ‘I don’t feel so good.’ The entire night, it felt like somebody had been sitting on my chest.”

He went to his doctor in the morning. She sent him straight to hospital. Tests revealed a heart attack but no obvious physiological cause. Doctors surmised that McLellan’s heart attack was stress induced.

“Stress is the number-one killer,” McLellan says. “It was a good slap in the face.”

“Broken heart syndrome”

Otherwise known as stress cardiomyopathy or takotsubo cardiomyopathy, this condition causes rapid and severe heart muscle weakness; can follow an event involving intense emotional or physical stress, including grief, fear, extreme anger, or surprise; and is more common to post-menopausal women.

McLellan, who now takes a daily aspirin (as a blood thinner), is keeping up with regular physical activity and healthy eating. Since his health scare, however, he sees things in a different light. His health and his family are the most important things in his life, and he doesn’t let work get to him. He’s training a replacement so that he can have more time away from the business.

“I’d rather be poor and happy than wealthy and dead,” he says. “Don’t think you’re ever too young or too invincible to have a heart attack. Stress can affect anybody.”

Warning signs

Chest pain is the most common sign of a heart attack for both men and women, says Cindy Yip, director of data, knowledge management, and heart program at the Heart & Stroke Foundation. Here are some other signs people may experience.

Women

  • Sore jaw
  • Back pain
  • Fatigue
  • Shortness of breath
  • Nausea
  • Indigestion

Men

  • sensation of squeezing, pressure, heaviness, fullness, or burning in the chest
  • pain or discomfort in the upper body, including arms, left shoulder, and stomach
  • rapid or irregular heartbeat
  • shortness of breath
  • light-headedness
  • cold sweat

Dr. Tara Sedlak, cardiologist at Vancouver General Hospital, says it’s important not to dismiss subtle signs.

“I tell people that when they have significant uncharacteristic pain lasting for more than 15 to 20 minutes in locations that could be associated with a heart attack, or severe breathing problems, or fainting with no warning, it’s always safer to get checked out than to stay at home and miss a possible heart attack,” she says.

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A version of this article was published in the February 2020 issue of alive Canada with the title “Matters of the Heart.”
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