Winter 2010: Of Note

Robin Whitworth with dogs

Lesson learned: Robin Whitworth, above with dogs, survived a mild heart attack.

Pat Thomas/PhotoPhetish

‘A Strange Sensation’

Heart attack symptoms may be subtle in women, placing them at higher risk

By Mary J. Loftus

Despite a family history of heart disease—her father had quintuple bypass surgery by his mid-fifties—Suwanee piano teacher Robin Whitworth, fifty-one, didn’t think she had to worry. She is thin and fit, doesn’t smoke, has regular check-ups, and stays active with her three rescue dogs.

So when she felt a strange sensation during a lesson with a student in August, she did what a lot of women do: she ignored it, a mistake that could have proven fatal.

“I had never felt anything like that before; it was as if I had the flu all of a sudden,” Whitworth says. “I didn’t really feel anything in my chest—it was more in my neck. I took Tylenol, chewed a piece of gum, anything I could to try to make myself feel better.”

Women more often than men may experience heart attack symptoms other than chest pressure or radiating pain. These include jaw, neck, shoulder, or upper back pain; abdominal discomfort, nausea, or vomiting; shortness of breath; sweating or dizziness; or sudden flu-like fatigue.

These more subtle symptoms may be due to the fact that women tend to have blockages not only in main arteries, but also in smaller arteries that supply blood to the heart.

When Whitworth’s fatigue returned a few days later accompanied by pressure in her chest and shortness of breath, she drove to Emory Johns Creek Hospital’s emergency department, where she had an EKG and was kept overnight. Blood work showed she had experienced a mild heart attack—one caused by a small artery that was 95 percent blocked.

Her condition is now controlled through medication.

“Risk factors that can be modified or controlled by medications or healthy lifestyle are high blood pressure, high cholesterol, physical inactivity, and smoking,” says Clinical Associate Professor Sheila Robinson, a cardiologist at Emory University Hospital Midtown. “Risk factors that cannot be controlled are age, family history, and previous heart attack or stroke.”

One in three women will develop heart disease, adds Professor Nanette Wenger, a cardiologist who helped write the national guidelines for preventing female cardiovascular disease. “So it’s important that we consider lifetime risks and not just short-term risks.”