Dr. Sarrel explains what a woman should do if she suspects she might be having a heart attack.
How could a woman help herself if she is actually starting to have inadequate blood flow to her heart? Well first thing of course is to think about it. We want to raise her awareness that this could happen and that it’s a very real phenomenon.
There are two times when women are most vulnerable if they are pre-menopause. It’s the middle of their menstrual cycle when they release an egg and at that time their blood estrogen drops and that can trigger the reaction or onset of period. So any kind of chest symptom, nausea symptom, numbness, jaw symptom that’s coming with the onset of a period – this is something to think about.
We also know that women who have, at menopause, hot flushes, when a woman as a hot flush she is producing a lot of adrenalin. You can measure it in her blood flow and what adrenalin does is to make arteries constrict. So if she is having a hot flush and she gets severe chest pressure, now I am going to have to temper that a bit because 35% of women, when they are having a severe hot flush, get chest pressure and they are not having heart attack; only a fraction are. So I don’t want to frighten everybody but I want to make the women aware that that symptom is a normal part of a hot flash but it’s something to pay attention to and report to your healthcare provider.
So the first step of course is preventive medicine – how to, knowing yourself that there’s something going on to be alert to. The most important thing is to keep a handle on things because if you get overly anxious you are going to pour out more adrenalin and that’s going to make the problem worse. If you can stop and say, “Oh, I think I know what’s going on; here’s something where perhaps I can just sit down, relax, talk to someone about what’s happening, perhaps call for help but maybe it will go away.”
When it happens though, that symptom, including the nausea that I talked about earlier, you certainly should either immediately or soon thereafter bring that to a healthcare provider’s attention because you should get studied to see what’s going on.
If you are an older woman, let’s say a woman in her 60s now, and you start to have that symptom, 911 is appropriate. You’ve got to call for help or get in a car and get to an emergency room and when you get to the emergency room tell them exactly what’s going on so that they can do the proper thing which would usually be to do an electrocardiogram because the electrocardiogram, which takes less than ten minutes to do, it’s going to tell them what’s going on.
We have actually had women and have a report in cases where women at the very beginnings of a heart attack have showed up in an emergency room. The electrocardiogram showed the beginnings of a heart attack and an intervention was able to be done that stopped it altogether and they never lost any heart muscle.
So yes, they had the artery constricting in on their blood flow but you can stop it, and if you stop it early enough you won’t lose any of your heart. So really the most important thing is to do something very early.
There is something else that would be very easy to do very early that anyone could do in her own household and that’s swallow an aspirin. You all have aspirin in your house and the first thing that a doctor is going to do with somebody, let’s say in a situation like on an airplane and someone’s going to have a heart attack, is to give him/her an aspirin because that’s going to help to oppose what goes into the makings of a heart attack that destroys muscle tissue. There’s no harm in doing that and it’s most likely going to be very helpful to you. You can all do that for yourselves.
So between calming down, contacting another person, having someone call for help or getting help yourself, taking an aspirin, you are on the way to preventing damage to your heart. See, there’s lots that you could do.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.