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Taking Aspirin a Good Step, but She Should Have Called 911, Expert Says
By Kathleen Doheny
WebMD Health News
Reviewed by Louise Chang, MD
Aug. 21, 2012 -- Talk show host Rosie O'Donnell, 50, advised women via her web site on Monday to learn the symptoms of heart attack and heed them after revealing she ignored her own and now feels ''lucky to be here."
The next day, a cardiologist diagnosed a heart attack. Doctors removed a large blockage from her coronary artery before inserting a stent to keep it open.
Her story is a timely reminder that women's heart attack symptoms are often different than a man's, and that women often wait too long to get emergency help, says Chrisandra Shufelt, MD, associate director of the Barbra Streisand Women's Heart Center, Cedars-Sinai Medical Center Heart Institute, Los Angeles.
Although chest pain can be a symptom of a heart attack for a woman, often the signs can be more subtle. In O'Donnell's case, she did complain of pain in both arms, which is a typical symptom. But according to the American Heart Association, women may also experience what are called "atypical" symptoms, including:
- Back, jaw, lower chest, or upper belly pain or discomfort
- Shortness of breath
Heart disease is the leading cause of death for U.S. women.
Rosie says on her site that ''it's a miracle'' she is still here. Do you agree?
I wouldn't call it a miracle. She definitely took the right steps to save her life, including the aspirin. Ideally she should have called 911 when she googled that information.
That is the information we need to get out -- that it's OK to call 911. It's important. Even if you are wrong. That delay can cause more damage.
What did the cardiologist likely do when Rosie arrived?
The cardiologist checked her blood pressure, her pulse, performed a physical, listened to her heart, and performed an EKG. That tells us a lot of information -- how the heart is functioning and if a heart attack is going on. He would have diagnosed the heart attack.
They performed an angioplasty [at the hospital] to see if there was any blockage. Once you detect a blockage, it's likely the source of her heart attack. [After clearing the blockage] they open it up with a stent.
Is it likely she had been ignoring symptoms for a while?
A large percentage of women have a set of symptoms up to a month before. Some women have cold flushes or break out in a sweat, a clammy sweat. Shortness of breath is a common symptom. Some women have stabbing pain in their back. So it's important to pay attention.
The classic Hollywood heart attack -- the elephant sitting on your chest, clutching your chest, chest pain -- can happen in a woman, but other symptoms can occur in women more often, such as shortness of breath, nausea, vomiting, overwhelming fatigue, or pain in the back or jaw.
Is it common for women to brush off symptoms like Rosie says she did?
I have heard this many times from women, that they wait, or they were too busy with the family or the children. They ignore their symptoms or didn't think much of it. They didn't think it could be a heart attack. I don't think it's uncommon.
I had one woman who took an hour-long bath [after symptoms set in].
What factor or factors likely triggered Rosie's heart attack?
Without knowing her history, it is hard to say which one factor or combination of factors. Five traditional risk factors all play approximately an equal role -- high blood pressure, high cholesterol, high blood sugar or diabetes, smoking, and family history of early heart disease, less than 55 for a man or less than 65 for a woman.
What about excess weight and stress?
Excess weight can contribute to heart risk factors such as blood pressure and diabetes, while stress can lead to increased chemicals and hormones in the blood stream, which raise blood pressure and heart rate.
What should women in Rosie's age range be doing about their heart health?
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For women entering their 50s, this is an important warning to have their heart risk factors evaluated. It's not only the average age of menopause, which of itself can be an important risk factor for heart disease.
What is Rosie's treatment plan likely to be, and what is the outlook for her?
It is important for her to take her medications. She would likely be put on an aspirin. She may be put on a second blood thinner. She will most likely be put on a statin, not just for cholesterol, but for inflammation.
We now want her cholesterol to be ultra low. Statins play a pivotal role in lowering inflammation.
She will likely be put on a beta blocker or ACE inhibitor -- they help heal the heart after a heart attack.
Cardiac rehabilitation is recommended for both men and women after a recent heart procedure such as a stent. This is a monitored exercise program to help reduce cardiac risk factors and is recommended for three times a week for three months. The program also includes nutritional counseling, stress management, and relaxation sessions.
I would predict she will have a very successful recovery.
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