February 23, 2000

Women feel the pains of heart disease

By Carol South
Herald contributing writer
       What began as indigestion turned into a triple bypass for Isabelle Claypool, who two years ago at 65 learned a surprising lesson: women are vulnerable to heart disease. Like most people, she assumed heart disease was more of a threat to her husband, Robert, than to her.
      Claypool never suspected heart trouble when she went to her doctor for a physical after her stomach began bothering her. A normal EKG indicated that her heart was fine, but an X-ray showed calcium deposits on her cardiac arteries. Her doctor referred her to a cardiologist, who found so many blockages in her arteries during a cardiac catheterization that Claypool had a triple bypass that day.
      "I knew there was something wrong," said Claypool, an East Bay Township resident. "I had such shortness of breath even just going up six steps."
      For her husband, it was a first-hand lesson that women are just as vulnerable as men to heart disease.
      "It scared me like hell," Robert said. "We never thought it would be her."
      Feeling fortunate to have now regained her health, both Claypools attended a lecture at Munson Medical Center last Thursday on Women and Heart Disease. There, Isabelle was a walking testimonial that this 'silent killer' stalks women as well as men.
      In a presentation led by Marianne Foster, manager of Munson's Cardiac Rehabilitation and Prevention program, an audience of more than 40 people learned that heart disease is the number one killer of women. In fact, heart disease accounted for 45 percent of all deaths among women in 1991. Deaths due to diabetes, accidents or other illnesses accounting for mere fractions of that number.
      Foster went on to bust a number of other myths about women and heart disease. She noted that the risk factors differ for the sexes, that women tend to fare more poorly after a heart attack, that standard diagnostic tests are not equal and that women tend to get less aggressive clinical care than men. In addition, women tend to have more complications and reactions to clot-busting medications than men do.
      Women do have a built-in advantage that gives their heart free protection for years: estrogen. However, once they are at a post-menopausal age, their risk of heart disease increases. Estrogen's natural protection means that women are experiencing heart disease at an average of 10-20 years later than men, when often they are older and have other physical symptoms that can hamper a diagnosis.
      "Women give vague presentation of heart disease," Foster said. "Even after successful treatment, more men that women go through rehab and their long-term prognoses are poorer."
      Most women present heart disease differently than men. Complicating this is that since many women are unaware that they are even at risk, they may not think that their vague discomfort can be related to their heart.
      Even when having a heart attack, women do not have classic symptoms people have come to expect in men: crushing pain radiating into the left arm, dizziness, nausea and so on. Research has shown that up to 25 percent never had chest pain at all and that women take longer to get to the emergency room than men do.
      Doris Quick, 75, had an emergency angioplasty and a stent put in last June. Like Claypool, Quick was typical in her nontypical heart disease symptoms and had no warning pains in advance. Even her husband, Bud's, heart attack 15 years ago did not prepare her for her experience.
      "I went to the emergency room I felt just a heaviness," Quick said. "My arms felt like lead pipes."
      Claypool is slightly atypical in her outcome, which has been very positive. She completed Munson Medical Center's Change of Heart Cardiac Rehab program and a follow-up program. She watches her diet carefully, walks two miles every day and stretches every morning. She and her husband also attend strength training classes at the Traverse City Senior Center.
      "In the support group I go to, not two people had the same symptoms," Claypool noted. "I always watched what I ate, except I liked sweets and chocolate; but that wasn't enough."