Wendy Wray RN, BScN, MScN
Director, Women’s Healthy Heart Initiative
McGill University Health Centre
Heart disease is a major cause of death in women, but many hesitate to seek help during a heart attack due to unclear symptoms or fear of burdening healthcare workers. Women often misinterpret chest pain and other symptoms. Quick medical attention is vital, and seeking help can make a life-saving difference.
Women’s Increasing Awareness
Heart disease is a leading cause of death in women. Over the past few decades, women’s awareness of their risk of heart disease has increased but remains woefully inadequate. Tragically this means women too often delaying seeking medical care when they are having a heart attack.
In our primary prevention women’s heart disease clinical practice, and when speaking with women in the community, too many reported having had symptoms but either did not recognize them, hesitated, or did not go to the ER for medical attention. When asked why, four concerns emerged.
1. Symptom Recognition- Chest Pain:
Many women were unclear about what symptoms to look for. Most knew their symptoms might be different when compared to men, and listed shortness of breath, sweating, nausea, fatigue and chest pain. Very few were aware that the most common symptom was chest pain and that the ‘pain’ they should look out for could be a discomfort such burning, heaviness, squeezing, tightness or pressure. Also often, as women, as nurturers and caregivers, we become quite adept at identifying the problem and taking care of it ourselves. Many women attributed their symptoms to causes other than cardiac. Unfortunately, by doing so, women,when having a heart attack, are putting themselves at unnecessary risk which could be fatal.
We want to make women aware that they might miss or dismiss their symptoms of having a heart attack because, as women, their concept of pain may be based on our painful lived experiences such as childbirth, painful menstruation or intercourse. Most of the women immediately identified with this reality.
2. Diagnosing a Heart Attack at Home:
Only a few women realized it is not possible to decide at home whether they were having a heart attack or not. They were unaware that three things- description of symptoms, an electrocardiogram and blood test are necessary to make the diagnosis. That assessment can only take place in a healthcare setting. We share these critical facts with them.
3. ER Wait Times:
Many women expressed hesitancy to go the ER because of the long wait times to be seen.
We suggest that when seen by ER triage nurse, women should make clear they have come in because they are concerned, they might be having a heart attack. This will ensure they receive care in a timely manner.
4. Healthcare System Burden Concerns:
Many women stated that should it turn out they were not having a heart attack, they would feel embarrassed or feel badly having burdened ER staff unnecessarily.
We explain that this would be good news for the staff to deliver as well as them to receive. We reassure them that the majority of patients presenting to the ER with chest pain/ discomfort are not having a heart attack. On the other hand, if they are having a heart attack, they will receive the care they need.
For more information on the topic watch this webinar: Women and Chest Pain: Overcoming Barriers to Timely and Fair Emergency Care and visit the Canadian Women’s Heart Health Alliance website at cwhha.ca.
