Beth Reese Cravey|Florida Times-Union
Among the female-specific risks for heart disease and stroke are pregnancy complications, physical and emotional stress andpoor sleep patterns, according to the 2021 Go Red for Womenspecial issue of theJournal of the American Heart Association.
Sharifah Abdullah of Jacksonville can relate.
In 2010shehad a difficult pregnancy, with fibroid tumors causing such intense pain she had trouble sleeping. In 2018she began having shortness of breath at night and again was often unable to sleep. After multiple doctor visits, medicationsthat did not work and her refusal to accept a diagnosis that anxiety was to blame, she was told she had aleaky heart valve and needed open-heart surgery.
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But Abdullahlived to tell the tale.
And she has a message for other women.
"Listen to your body," she said. "I got through it because I listened to my body.… So many people don't. You can't brush it off and deal with it later. Later never comes."
Female-specific risks for heart disease
The American Heart Association Journal special issue, released onlinethis year, cited multiple research studies showing that women face many female-specific risks for heart disease and stroke. Pregnancy, physical and emotional stress, sleep patterns and numerous physiological aspects "are among the many unique factors found to contribute to increased cardiovascular risks for women," according to the journal.
Journal Editor-in-Chief Barry London said,"Although cardiovascular diseaseis the leading cause of death in men and women, women are less likely to be diagnosed and receive preventive care and aggressive treatment compared to men … Identifying and addressing the unique ways cardiovascular disease affects women is critical to improving outcomes and saving lives."
Pamela Rama,a cardiologist with Baptist Heart Specialists, said she was familiar with the report. She said getting a detailed history of pregnancy-related complications is animportant part of evaluating their female patients.
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"We in the cardiac community recognize pregnancy as a cardiometabolic stress testbecause of significant physiologic changes that occur during this ninemonths to accommodate the growing fetus," Rama said.
The heart adapts to the increased cardiac demand in many ways, she said.
"Heart rate usually increases and the blood pressure drops in the first trimester of pregnancy and goes back to normal during the second trimester," Rama said. "Not to mention the hormonal changes that come along with this."
Rama advised women to reduce their heart disease risk by adopting a "heart-healthy lifestyle," such as not smoking, being active and maintaining a healthy weight. Women who had gestational hypertension during pregnancy should limit theirsalt intake and monitor their blood pressure for the development of high blood pressure; if they had gestational diabetes, theirblood sugar should be monitored.
"Make sure youlet you let your doctor know if you have had pregnancy-related complications," she said.
Heedlessons learned
Rama also recommended women learn Abdullah's lesson.
"You know your body bestand women may present with atypical symptoms," she said. "If you feel that there is something wrong with you, insist that you be worked out for a possible cardiac condition. Never accept anxiety as the diagnosis.
"I always tell my colleagues that when someone comes to you with symptoms of shortness of breath, palpitations, lightheadedness or chest pain, anxiety should never be your top diagnosis," Rama said. "There are cardiac conditions that can be life-threatening, yet preventable."
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If necessary, she said, "Seek a second opinion. This is your right as a patient and this may save your life."
Abdullah, 37, who is African American, said she had no idea of potential connections between pregnancy, sleep issues and heart disease. She's just happy to be alive, she said.
Her medical journey began at age 22 with the fibroids, which initially caused heavy menstrual bleeding. Medication stopped that problem. But when she became pregnant in 2010, she said they caused "so much pain" and enlarged her size.
"You would have thought I was having twins," she said.
In 2012the fibroids were removed. Six years later,at night her heart would race and she had difficulty breathing. Abdullah said her primary care doctor said "it was just anxiety" and prescribed one medication, then another.
"I believed something else was going on with me," she said. "I'm still gasping for air."
A cardiologist initially agreed with the anxiety assessmentbut then prescribed a sleep monitor, which provided no answers, and an echocardiogram, which did. The machine uses sound waves to produce images of a heart and showed the leaky valve.
"Blood was flowing backward instead of forward," Abdullahsaid. "I had to go through all this. I know my body. I was so glad."
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News that she needed open-heart surgery was frightening. She was told that without it, "your heart will deteriorate and you would probably die," she said. "There was no way out."
But finally "to know what it was" came as a relief, she said, after "not knowing if I was going to wake up when I went to sleep at night."
Abdullahhad the surgery in 2020 and is now doing well. Her son, now 10, knows she had a medical problem of some kind but likely doesn't understand the severity. He also may not realize the role he played in her recovery.
"I havea son I need to get home to," she said. Fixing her heart so she continues to wake up in the morning, she said, "It'sa blessing."
Beth Reese Cravey: (904) 359-4109, bcravey@jacksonville.com
BY THE NUMBERS
• Cardiovascular disease is the No. 1 killer of women, causing 1 in 3 deaths each year.
• 90 percent of women have one or more risk factors for developing heart disease.
• Of African American women ages 20 and older, 49 percent have heart disease.
• As much as20 percentof women will have some kind of health issue during pregnancy.
• Black women were three times more likely than Hispanic women and 2.5 times more likely than white women to die from causes linked to pregnancy.
HEART ATTACK SYMPTOMS FOR WOMEN
• Chest pain, but not always
• Pain or pressure in the lower chest or upper abdomen
• Jaw, neck or upper back pain
• Nausea or vomiting
• Shortness of breath
• Fainting
• Indigestion
• Extreme fatigue
STROKE SYMPTOMS FOR WOMEN
• Numbness or weakness in face, arm or leg
• Trouble speaking or understanding speech
• Vision problems
• Trouble walking or a lack of coordination
• Severe headache with no known cause
• General weakness
• Disorientation and confusion or memory problems
• Fatigue
• Nausea or vomiting.
Source: American Heart Association
For more information about women and heart disease, go togoredforwomen.org. For more information about the May 14 First Coast Go Red for Women Digital Celebration is May 14. For more informationgo tobit.ly/334nFqa.
