Holistic Centre for Body, Mind & Spirit

Are You Sure Your Headache Isn’t a Heart Attack?

Cardiovascular disease has long been considered a men’s health issue – but more women are dying from it.

NOVEMBER 2011, THE TIMES

“I began to get a headache like I had never had before” says 37-year-old Priscilla Chandro. “It was intense, but I didn’t know what caused it. I went to the kitchen to get paracetamol, but on the way I felt so hot I had to lie on the sofa. Once the wave of heat had passed, I got up again. But then I passed out and woke up staring at the kitchen ceiling.”

What Chandro was suffering from was in fact a massive heart attack. She did not believe it had happened to her. But neither did the paramedics who had rushed to her home, who said she had flu. Nor did a GP who initially examined her. It wasn’t just that Chandro, a working mother of a four-year-old daughter, from Ottershaw, Surrey, had a normally healthy lifestyle and no family history of cardiovascular disease. The symptoms of heart attacks in women are often much subtler and very different from those in men. And we still somehow don’t believe that women get heart disease, even though it kills three times more women than breast cancer does.

Finally scientists and doctors are accepting that women’s coronary problems are physically different from the male model upon which medical therapies are traditionally based. This opens a path to new treatments and preventive tactics. And not before time. For although coronary heart disease is considered a problem for over-weight middle-aged businessmen, it is in fact the most common cause of death for British women.

Emotional stress may play a role in some forms of women’s heart disease. Last week it was reported that research by the University of Arkansas showed that shock or emotional trauma can damage the heart. It also stated that women are seven and a half times more likely to suffer “broken-heart syndrome”, or stress cardiomyopathy, a condition where intense emotional or physical stress can cause rapid and severe heart-muscle weakness, than men.

Vera Regitz-Zagrosek, director of the institute of gender in Berlin, says that high psychological stress plays the key role in 90 per cent of cases of a particular form of heart failure in women. “We are only just becoming aware of how much women are in danger from this syndrome,” she says.

Chandro says: “A heart attack was the last thing I could ever have imagined. It seemed like a cruel joke; not something that happened to women, especially young ones. I felt extremely frightened. People just don’t believe that it could have happened to me.”

But it frequently does, according to Jane Flint, a consultant cardiologist who chairs the British Cardiovascular Society’s joint working group for women’s heart health. “In 2010, 77,000 men died from cardiovascular disease. The same year, 80,000 women died from it,” she says. “A third of deaths in men are from this, and a third of deaths in women are too.”

One reason for the female death rate is that women tend to wait longer than men before calling 999 after first experiencing heart attack symptoms. Experts speculate that this might be because women are reluctant to cause a fuss, or they don’t want to be embarrassed if it turns out that their situation isn’t serious.

The difference in symptoms also plays a role. Many men’s heart attacks fit with the picture of chest pain that spreads to the shoulder, arms, back, teeth or jaw, along with shortness of breath. Women’s signs can be much more vague and insidious.

A study of 500 female cardiac patients by the National Institute of Nursing Research reports that the most common symptoms that women experienced in the month before a heart attack are unusual fatigue, sleep disturbance, indigestion and anxiety. Forty per cent had no chest pain, even during an attack. Other research says that women are more likely to experience achiness or tightness across the chest during a heart attack, along with symptoms such as pain in the jaw, nausea, sweatiness, breathlessness and feeling light-headed.

But it is not only the symptoms that are different. The physical causes of women’s heart attacks can differ considerably too, and therefore require different treatment. Last week, leading cardiologists gathered at the University of Mississippi to explore these disparities at an international conference. High on the agenda was research suggesting that while men commonly suffer blockages, specifically in the arteries supplying blood to the heart, women’s heart disease is often spread more widely in their bodies. Dangerous fatty clots accumulate more evenly inside women’s major arteries and in smaller blood vessels.

Because women’s arteries are generally smaller than men’s they are more easily blocked. And the widespread nature of potential blockages makes it harder to diagnose the disease in a woman, and makes it more deadly if she has a heart attack, the conference was told by C. Noel Bairy Merz, the director of the Women’s Heart Center in Los Angeles. His figures show that more than a third of women will die within a year of their first heart attack, compared with a quarter of men. Women are twice as likely as men to have a second heart attack within six years for their first, he adds, and women are twice as likely as men to die after bypass surgery.

In addition, medical research often fails to differentiate between men and women in tests of drug therapies. Dr Flint says: “We know that heart drugs can have different effects according to your gender. But only half of the drug trials conducted into heart drugs since 2006 showed results by gender. And of the people tested, two thirds were men.”

Dr Flint says that statin drugs offer a clear example of the importance of gender-specific-research. “Until recently, it was thought that women did not benefit from taking statins the way that men do. Thankfully, research shows otherwise now, though that is little comfort to women who have missed out. And even now, only about a third as many women are given statins as men. The message has not yet fully got out.”

Other drugs can have totally different effects on the sexes. Only in 2009 was it discovered that a daily aspirin regimen for men helps to protect against heart attacks, but offers no protection for women. (On the other hand, that same aspirin will protect women against strokes but has no such power for men.)

Lifestyle plays a part too. The British Heart Foundation reports that about a third of women in England and Scotland have high blood pressure. More than half of all women in the UK are overweight or obese and less than a third in the UK do enough exercise to protect their hearts.

For Priscilla Chandro, the idea of emotional stress playing a part in her heart attack feels particularly true. “I am convinced that my heart attack was brought on by all the intense emotional stress I had put myself under. After it happened, I decided to deal with all the sadness and anger that I had always carried around with me, to change my attitude and beliefs.”

Chandro was extremely lucky to have survived her massive coronary, given the late diagnosis. If more of us learn to watch for the subtler signs of a female heart attack, many more women may get that second chance of life, too.





The symptoms for Women

The most common symptoms that women experience in the month before a heart attack are, say researchers:

  • Unusual fatigue, which was noted in 70 per cent of the women monitored
  • Sleep disturbance, which affected nearly half of them
  • Shortness of breath
  • Indigestion
  • A heightened sense of anxiety

During a heart attack, further research shows that women may feel:

  • Tightness across the chest (although 40 per cent of women don’t feel any chest pain)
  • Pain in the jaw
  • Nausea
  • Sweatiness
  • Breathlessness
  • Light-headedness

John Naish




Are You Sure Your Headache Isn't A Heart Attack?

At Anam Cara we teach and support our clients to take full responsibility for observing and gaining insight into their own health and wellbeing on all levels: physical, emotional, psychological and spiritual. Clients must be willing to be conscious of themselves on the most intimate of levels, thus helping them to access their own inner wisdom and knowing. When you experience physical symptoms, it is always for a reason and we guide and support our clients as they learn to interpret those symptoms and address the related issues.

We have many ways in which we can do this. The body is speaking and it’s our job to understand how much you can hear; once we understand that, we’ll help you understand how, via lifestyle diagnosis, naturopathic medicine and nutrition, you can respond. Lab tests and supplement programmes may also play a part in understanding how the body is expressing you deeper concerns.

Through this work, the individual becomes ever more sensitive and attuned to any disharmony or struggle within their psyche or body. They are better able to discern and respond to illness or disease, and come to understand not only symptoms, but their origins. This goes for all experiences, from the most apparently inconsequential to the most serious and life threatening. Our clients don’t have to try and make these discoveries in isolation - we’re always here to help them deal with it and pick up what they may have missed before.

We are complex beings and we need to pay attention to ourselves.