Heart disease alone is the second most common cause of death in Singapore, accounting for 24.1 per cent of total deaths in 2007. Contrary to popular perception, it is not a disease that mostly affects men. In fact, cardiovascular disease in women is more common than most of us realise. It is one of the leading causes of death, accounting for 33.4 per cent of female deaths in 2007, according to Ministry of Health statistics.
Although men have a higher prevalence of heart disease than women, "the risk of heart disease for women catches up to that of men usually 10 years post-menopause", says Dr Jack Tan, a consultant cardiologist at National Heart Centre Singapore (NHCS).
While women are as likely as men to have a heart attack, they are more likely to die after their first heart attack.
That's because women are less likely to recognise the symptoms, and so take longer to seek medical help. Statistics also show that by the time they get to the hospital, health workers are less likely to recognise them as having a heart problem and give them early intervention.
The warning signs all women should know Symptoms of a heart attack vary. Most people will have the classic central chest pain which radiates to one arm or another. However, women are more likely to have atypical or unusual symptoms such as breathlessness, palpitations, light headedness, and anxiety - and they could experience these without any chest pain.
It is actually not uncommon for a person to experience such atypical symptoms such as pain in the epigastric or upper abdominal region as well as lower chest pain, according to NHCS's Dr Jack Tan. This is true especially for diabetic patients.
The early warning signs of a heart attack usually last for at least 10 minutes, and you may experience one or more of the symptoms. These include:
Pain in the chest
A heart attack usually causes discomfort or pain in the centre or slightly to the left of the chest. The pain usually comes on suddenly but can occasionally also start slowly, develop over minutes, or come and go.
Radiation of pain
The chest discomfort may spread to the neck, throat, jaw, and to the left arm.
Discomfort in the upper body
Some people don't get chest pain - only discomfort in parts of the upper body. There may be a feeling of choking in the throat, epigastric discomfort ,or the arms may feel "heavy".
Unusual symptoms
There may be shortness of breath or some difficulty breathing, nausea or vomiting, a cold sweat, or a feeling of being dizzy or light-headed, or restlessness.
Extreme tiredness
A study of 515 women published in the journal Circulation found that the most common early warning sign of a heart attack in women was unusual fatigue.
What is a heart attack? A heart attack occurs when there is a complete blockage of an artery that supplies blood to the heart. Such a blockage can occur when cholesterol forms a plaque in the artery wall. The surface of the plaque can crack suddenly, exposing the blood to that cholesterol. A blood clot then forms on top of the plaque - this blocks the artery and impedes blood flow to the heart muscles, thus resulting in a heart attack. The cessation of blood flow to the heart causes some of the heart muscle to die. Without early treatment, this damage will be permanent.
Patients who experience new chest symptoms or sudden chest pains should get immediate medical attention. It is best to call in an ambulance rather than drive or take a taxi to the hospital. If the symptoms are atypical, one can see her family practitioner for an opinion first. Usually a simple test like an electrocardiogram or ECG is then performed.
Rapid treatment of a heart attack is the most important determinant of outcome. In cardiology, there is a common saying: "time is muscle". The earlier treatment is initiated, the more muscle is saved, and there will be less downstream effects of heart failure and death.
This article was contributed by National Heart Centre Singapore (NHCS) and is part of a new series on heart health.