Alba, Alina and Margarita's daughter have shared with us, through CLARA.es, a vital moment as hard as having a heart attack or having a loved one suffer it. If something emerges from their testimonies, it is that none of them knew how to recognize what was wrong with them and that the doctors who treated them or confused the diagnosis or gave them an electrocardiogram, but more to rule out than to believe that they suffered a heart attack.

"I didn't know how to recognize what was happening to me"

Testimony of Alba, heart attack at 45 years

I suffered from angina pectoris on March 4, 2017. I noticed a pain that I had never experienced but it did not last long, about 30 seconds. I felt a sensation of imminent death, but then there was no residual pain left, so I went shopping. In fact, I told my daughter and said verbatim "I thought I was having a heart attack" and you see … Deep down I knew that my heart was not going well. On the 24th, while walking with my husband, I began to feel that intense pain again. After a while, it passed me. I got home and made dinner. When I finished, the pain returned, much greater and lasted an hour. It was a heart attack. I got into bed to see if it would pass, but it got worse … In the end, I expelled a lot of gas and the pain went away. I thought that was it. The next day,the pain was already almost constant and I started to get so bad that it was difficult for me to breathe and I could hardly get up because I was tired. At night, a few minutes after I fell asleep, I started having seizures, and then my pulse was gone. She had just reinfarcted and entered cardioonductiratory arrest. My husband managed to revive me, and from there to the hospital.
The result was a heart attack that causes the death of part of the heart muscle. Fortunately I survived. This happened to me when I was only 45 years old and without any previous risk factors, no cholesterol, etc.

The heart attack is still read in masculine code

It is true that for 70 men who suffer a heart attack, there are 30 women. The problem is that it kills us more, since in the end the death figures are not so different: 213,309 men for 209,259 women in 2015. Why? Because we “fall ill at a later age and we also arrive at the hospital later,” explains Dr. Fina Mauri, head of the Hemodynamics and Interventional Cardiology Unit at the Germans Trias i Pujol University Hospital.

56% of men are well diagnosed with a cardiovascular problem by 15% of women.

Why don't we run to the ER?

Dr. Mauri is very clear: “To diagnose something, you first have to think about it. If you are not aware of what the pain you feel indicates, you cannot identify it ”. Men tend to associate their symptoms with heart attack faster. In the case of women, this does not happen. Women tend to minimize symptoms, not to give them importance, we can attribute them to a thousand things less to the heart.

Doctors must change the chip too

The 2019 study Sex and gender in cardiovascular medicine , published in the European Heart Journal , highlights that "women continue to experience greater delays in terms of care and less aggressive treatments."

Our heart is different. This study adds that, despite the differences between the anatomy and functioning of the woman's heart compared to that of men, we receive the same treatments as they because the studies are usually done only with men.

Original text

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So you can recognize that you have a heart attack
A myocardial infarction can give symptoms even a month before it occurs, according to a study by the Heart Institute at Cedars Sinai (USA). These symptoms will help you recognize it:
Tightness in the center of the chest. The best known symptom, common to men and women, is pain that lasts a few minutes and then disappears, only to reappear later, becoming more and more intense. This pain can radiate to other areas, such as the left arm, something more common in men, but also to both arms or to the back, neck or jaw, more common in us.
Difficulty breathing. In women, shortness of breath, a feeling of suffocation or a persistent cough can alert you to a heart problem. These problems can be a sign that the heart is not able to pump well.
Unusual tiredness . If you have not made changes in your life and you feel very tired, it may be your heart. More than half of those who have suffered a heart attack describe feeling great muscle weakness.
Digestive disorders Women can experience nausea, vomiting, abdominal discomfort or pain, gas or heartburn in the previous days. "Many times, the manifestation during the heart attack is this", explains the doctor.
Seasickness . If the heart does not pump enough blood to the brain, you can get dizzy, feel lightheaded, have balance problems, blurred vision … If, in addition, you notice palpitations while at rest, consult your doctor as soon as possible. Remember that although 80% of women have symptoms identical to those of men, you can be one of the 20% who have different symptoms. In other words, don't just look at the pain in the chest or left arm.

Who Should Watch Even More
There are women who have a greater risk of heart attack and who should take extreme prevention. They are those who have had gestational diabetes, gestational hypertension or pre-eclampsia and also polycystic ovary, early menopause, lupus, etc.
And if you have the flu, stay tuned … An Australian study found that after suffering from the flu there was 6 times the risk of heart attack, especially if there were other factors such as diabetes, cholesterol, high blood pressure …

"I suffered it after a cesarean section and did not realize it"
Alina's testimony, heart attack at 36
12 days after a cesarean section, I had a heart attack caused by a coronary dissection. In the early morning I woke up with a strange feeling of discomfort and my chest hurt, but since I was breastfeeding the baby, I thought of a rise in milk. We called the doctor and he recommended that I go to the health center where they gave me an electrocardiogram and it was a heart attack! I owe my life to the ER doctor who treated me, because I was a 36-year-old woman, with no risk factors, a new mother, breastfeeding … She could not have done an EKG, but she did. Her face when she saw the screen I have engraved on my retina. Neither he nor I thought at any time that he was having a heart attack. And it is that, in my case, the pain was not as they say, as a sensation of imminent death,it was something like a continuous tightness in the center of the chest but it did not make me unable to move (neither radiated nor removed, it was there). Another symptom I had was nausea, I remember it all as a feeling of restlessness that invited me more to take a linden than to take a cafinitrine …
After two urgent catheterizations, 10 days in the hospital and 4 stents, I was able to return home with my baby. I had a second heart attack seven years later and, from previous experience, I knew from the first moment what was happening, but the symptoms were just as "mild" in appearance …

Consequences of not running to the ER
They depend on the severity and speed of receiving care.
Greater risk of suffering another. After a heart attack, the risk of cardiovascular complications increases, such as a new heart attack, aneurysm, stroke. Therefore, a daily medication is usually recommended.
Heart failure. It is one of the most feared sequels after a heart attack. The heart cannot pump again as when it was healthy and this affects the quality of life, because it causes fatigue, shortness of breath, swelling in the legs or belly, arrhythmias …
Death. After stroke, heart attack is the cardiovascular disease from which more women die, ahead of breast cancer, which is usually what worries us the most.

Ask for an EKG
Don't hesitate, claim it. Dr. Mauri advises us to ask for an electrocardiogram if we suspect that we may be having a heart attack.
But first, watch your risk. The specialist is exhaustive in stating that "just as we go –or should we go– once a year to the gynecologist, we should also check our cholesterol, blood pressure, weight and physical condition …".

What to do if you have a heart attack
Call 112. The Spanish Heart Foundation recommends calling 112 and waiting for the ambulance to come, not going to the hospital directly.
Keep calm.Try to relax, controlling your breathing, because nerves raise your blood pressure.
If you doubt …Go to your health center if you have pains that come and go, but if they persist, call 112 for a faster intervention.
Don't downplay it. Remember, if you are not feeling well, there is a reason. Better that it be a doctor who decides what is due.
If it's not you According to the SAMUR First Aid Guide, you must call 112 and make the patient comfortable, loosen his clothing and keep him cool.

"He died of a heart attack but they told him it was the flu"
Testimony of Margarita's daughter, heart attack at 77 years

Prevention is not just looking at cholesterol, and your mental load?
It is true that tobacco, cholesterol and high blood pressure are risk factors that must be taken into account, but as Dr. Mauri explains, "the mental burden and psychosocial factors affect us women more."
To meditate. Among the recommendations that the doctor makes to prevent heart attack is learning to meditate and do it regularly. "The trigger for the heart attack can be emotional, therefore, we must avoid emotional stress," explains the specialist.
Manage our time . "Women have joined the world of work, but we continue to carry the responsibilities of the house, of the children …". Therefore, we must learn to delegate, to better share responsibilities.
And yes, weight, cholesterol and blood pressure should be in check. Following a healthy diet such as the Mediterranean helps you take care of your heart. According to the Predimed study (Prevention with Mediterranean Diet), following this diet reduces the risk of myocardial infarction, stroke or cardiovascular death by 30%.
Stay active. According to the University of Queensland (Australia), a sedentary lifestyle is worse for the heart (it has a greater influence, above tobacco, hypertension or obesity).
Sleep well . According to the Chicago Medical School (USA), sleeping less than 6 hours a day usually doubles the risk of cardiovascular accident, and more than 8 hours increases that of angina pectoris and heart attack.