National Emergency Medicine Assoc. (NEMA)


HeartLINES ...a quarterly report to friends of The National Heart Council, a special program of the National Emergency Medicine Association

Page 1: Summer 1997 VOLUME 13 ISSUE 1

Dear Friends and Supporters and Supporters,

Mom, apple-pie and babies. The traditional view of women has seriously impacted the way women seek and receive medical care for heart disease. Until recently, women were not included in medical studies for heart or other serious diseases in the belief that menstrual cycles, pregnancy and menopause would affect the veracity of the findings.

It was not recognized that the symptoms for heart attack can be very different for women than they are for men. Women’s symptoms more closely resemble those associated with stress and anxiety, so they are often treated by doctors as a "nervous condition."

Frequently, women them- selves maintain the false attitude that it is the husband that needs to be careful about a possible heart attack, it doesn’t happen to women.

Consequently, women wait too long before seeking medical advice for heart disease prevention or care, symptoms are misdiagnosed until its too late or the medical knowledge that will help them is simply not available. Recent studies find women consistently under-diagnosed and under-treated for symptoms that indicate heart disease.

It is important for women and doctors to admit that heart disease is an equal opportunity killer and treat it as such. Attitudes are changing as media reports make the public more aware of the discrepancy. Now it’s up to individual women to address the issue for themselves. 

Learn your family history for heart disease, know not just the typical symptoms of heart attack but those more typical to women, talk to your doctor about changes you can make in your lifestyle and eating patterns, be aware of the risk factors for women. Most important, don’t risk your life by pretending it can’t happen to you. It can and does.

Take symptoms of heart attack as seriously for yourself as you would the man in your life. If symptoms occur, get medical care immediately. Be sure your doctor considers and tests for heart disease. Be as conscientious about your treatment and recovery as you would be if it was your husband or father. Ease up on feeling responsible for others and allow them to help love and care for you.

Howard H. Farrington, President

 Women-Mind Your Hearts

Women are, historically, the care givers, showing little care for themselves when a loved one requires their care and devotion. Combine this with another historical fact- that until recently medical studies did not include women – and we have an attitudinal condition that can be deadly for a women. Not only do doctors not always know enough about heart disease in women to confidently diagnose and treat them, women themselves ignore symptoms and fail to seek medical help in time to prevent serious heart damage.

Few women realize that the symptoms they may experience for heart attack can be very different from the male symptoms we are usually taught.

"We are taught that a heart attack is a man's disorder." Robin Simpkins -
Cardiopulmonary clinical nurse, Mary Black Memorial Hospital

The classic symptoms usually experienced by men are a crushing pain in the chest, radiating out through the shoulder and left arm. Women are more likely to complain of shortness of breath, extreme fatigue and a mild chest pain. Often the pain is described as more of a heaviness or burning sensation that occurs in the chest, arms, jaw, neck or cheek. It’s easily dismissed by the woman or her doctor as symptoms of stress.

The danger in this delay of treatment is increased by the fact that two out of three women with highly elevated blood pressure, do not know they are hypertensive. Neither the woman, nor the doctor is accurately assessing her critical level of risk for heart disease and stroke.

More than a third of the women with diabetes don’t know it and over 60% of those that acknowledge diabetes, fail to keep their blood sugar levels under control.

Dr. Andrew Friedman, a Middletown, PA. cardiologist, thinks "there is a tendency for women to ignore pain, and…show up at the doctor’s office with a more progressed disease…For the same reason, when they have a heart attack, they ignore it a little longer."

Another Middletown cardiologist, Dr. S. Chivukula says studies indicate more women work and smoke and still do the house work and childcare. He feels this stress contributes to the incidence of coronary artery disease.

Before experiencing menopause, many women seem to be somewhat protected from heart disease by the hormones they produce. Within five years after menopause this benefit is lost. Women’s arteries start to clog and heart disease develops more quickly than in men because their arteries are smaller. This makes women more likely to die during a heart attack or bypass surgery.

Ladies, be aware of the symptoms of heart disease and don’t ignore them. Have regular check-ups that include blood sugar levels, waist-to-hip ratios and stress testing. Watch your diet and exercise regularly. If you experience symptoms of heart disease, be sure your doctor takes you seriously and completes all the necessary testing procedures that will accurately determine your level of risk for heart disease.

Doctors are getting the message, now it’s time for women to get the message, too.

  New Technology-Check With Your Doctor

There are two new procedures available to heart patients that you may want to ask your doctor about. 

1. The National Heart, Lung and Blood Institute reports that an implantable defibrillator for life-threatening heart arthymias, has produced good results in clinical trials. Deaths were reduced by nearly 38% as compared to those using the more typical antiarhythmic drug treatments.

2. Beth Israel Deaconess Medical Center has had excellent success in using a newly developed flexible stent. Developed by C. R. Bard, the XT Stent makes it easier to deliver and place a stent in arteries where current designs are too rigid. It may be possible to complete the entire procedure with a single balloon catheter. The result is both a more comfortable implant and a cost savings for patients.

Be Alert to the Symptoms of Heart Disease

 Studies indicate that women are often protected from heart disease by the hormone estrogen. But after reaching menopause, the benefits of estrogen is lost and statistics of heart disease for women rapidly catch up to that of men.

Women’s Symptoms

Tightness or pressure in the chest- may be mild compared to men. May radiate down arm, jaw, neck or cheek.
Fatigue, weakness- could be more severe than is typical
Feeling light-headed, dizzy or fainting
Swelling of legs and ankles- weight gain from fluids
Frequent shortness of breath- waking up breathless at night, wheezing attacks

Men’s Symptoms

Crushing chest pain- often radiates down neck and jaw, may spread across shoulder and down arm. Less severe pain may also be serious- don’t ignore any continuous pain.
Sweating- without exertion or more than usual
Nausea- without reason
Rapid heartbeat- that comes on suddenly or without exertion
Feeling confused

If you experience these symptoms, it is important to seek medical advice immediately. The only way your doctor can be certain whether you have heart disease is for you to undergo testing that may include:

* Blood and urine tests

* Chest X-ray

* Electrocardiogram (EKG) – measures heartbeat and electrical activity

* Echocardiogram – uses sound waves to show the heart and how it is functioning

* Stress test- uses a tread mill to compare resting and active rates of the heart

* Cardiac catheterization- uses catheters in the heart to look for clogged arteries or other structural problems

Myocardial perfusion imaging is a more accurate indicator for women with heart symptoms, but current reimbursement policies require a stress test first. This means women must take and pay for two testing procedures to gain the more accurate results.

 (Medical Post, Dr. Arfan Al-Hani and Family Circle, Margit Feury)

 Update on NEMA’s "In A Flash"

Since first telling you about our "In A Flash" gun violence prevention program in the spring HeartLINES, NEMA has given over 700 free copies of the video and resource materials to middle schools throughout Maryland and Washington, D.C. Teachers and administrators have responded with accolades. The program has been recommended by the National Education Assoc., the Safe and Drug Free School Program and the National YWCA. We are looking for funding that will enable us to offer the program to schools nationwide.

The Heart of The Matter 

NEMA produces an award winning radio health show, The Heart of The Matter, broadcast daily nationwide. The lively interview format provides current information on a wide range of health and healthy lifestyle topics.

For stations in your area that broadcast The Heart of The Matter, call 1-800-332-NEMA. Copies of transcripts are free and cassettes are available for $4.50. You can download transcripts or access the NEMA, Heart Council and Stroke Council home pages on the internet at: ***or**** e-mail:

Giving More Can Cost You Less

The Internal Revenue Service provides special incentives to encourage charitable contributions. Careful estate planning with a knowledgeable advisor allows you to benefit from tax savings now and protect your estate from unnecessary death taxes later, while still protecting the inheritance of your loved ones, plus making a charitable donation to an organization such as NEMA. (FIND OUT MORE)

Talk to your lawyer or financial planner about capital gifts, Life Income Gifts and Charitable Remainder Trusts or call NEMA at: 410-494-0300.


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Copyright 1997 National Emergency Medicine Assoc., Inc.
Last modified: January 23, 2022