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Heartburn or heart attack? Women and men are different


Earlier this year, the American Heart Association published its first scientific statement on heart attacks in women, highlighting some notable gender and racial disparities in cardiovascular events and outcomes. The study indicates that a woman’s heart attack may have different underlying causes, symptoms and outcomes compared to men, and differences in risk factors and outcomes are further pronounced in black and Hispanic women, according to a scientific statement published in the American Heart Association’s journal Circulation.

“Despite stunning improvements in cardiovascular deaths over the last decade, women still fare worse than men and heart disease in women remains underdiagnosed, and undertreated, especially among African-American women,” said writing group chair Laxmi Mehta, M.D., a noninvasive cardiologist and Director of the Women’s Cardiovascular Health Program at Ohio State University.

What causes heart attacks?

Most often a heart attack is caused by blockages in the main arteries leading to the heart and can occur in both men and women. Think of a clogged drain or blocked fuel line. Often, this is caused by too much cholesterol in your diet, which basically causes rust to build up in your pipes.

What are  heart attack symptoms?

While the most common heart attack symptom is chest pain or discomfort for both sexes, women are more likely to have atypical symptoms such as shortness of breath, nausea or vomiting.  Other symptoms that both men and women may experience are pain or discomfort in one or both arms, weak, tired, breaking out in a cold sweat, lightheadedness, back or jaw pain, an uncomfortable pressure, squeezing, fullness or pain in the chest. People often say it feels like an elephant is sitting on their chest. If you notice any of the symptoms on yourself or anyone around you, call for immediate medical attention.

Several years ago, my friend Capt. Rob noticed he was feeling tired earlier in the day. He was also sweating more than usual, but being out in the hot Florida sun working did not raise any concerns. About the same time, he noticed indigestion or heartburn so he started taking Zantac. He wasn’t sure what it was, but he knew he did not feel well. After several days of this he decided to go to the doctor. Upon his arrival to the doctor’s office he was informed that he was having a heart attack. Happily, my friend survived.

While teaching a class in Pennsylvania, a student shared a similar story with the class.  When he was 40 years old, he started to feel really bad heartburn and indigestion. He started to drink Maalox antacid. For two weeks, this feeling continued and he continued to drink the Maalox.  Then one morning, a new symptom began. He said it felt like someone stabbed him with a two-by-four between the shoulder blades and lit it on fire. At this, point he dialed 911 and was flown by helicopter to the hospital for surgery. Happily he survived.  

The two stories above are not uncommon. Chest pain may be an indication of a heart attack or it may only be heartburn. The problem is that it can be difficult to tell the difference.  

Sometimes our body sends signals to the brain that don’t always sound logical. I had two female students that experienced heart attacks and they both felt the pain in their elbows. Normally we don’t associate elbow pain with heart attack, but it can happen.

Chest pain can be a heart attack, but it can also be a gastrointestinal problem such as ulcers, muscle spasms in the esophagus, Gastroesophageal Reflux Disease (GERD), a gallbladder attack, and pancreatitis. Often they can cause chest pain and symptoms that are similar to a heart attack or angina.

Angina is chest pain or discomfort that occurs if an area of your heart muscle doesn’t get enough oxygen-rich blood. Often, angina feels like pressure or squeezing in your chest or like an elephant sitting on your chest. The pain also can occur in your shoulders, arms, neck, jaw, or back.

Keith Murray is the owner of The CPR School, Comments on this column are welcome at

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