Cardiovascular disease is the Number 1 killer of women over the age of 25 in the United States, regardless of race or ethnicity.
Most people think breast cancer is the leading cause of death in women. But cardiovascular disease claims the lives of more women than all forms of cancer combined.
1 in 3 American women dies from heart disease.
Since 1984, the number of female deaths from cardiovascular disease has exceeded that of males and it continues to increase.
1 in 4 women has some form of cardiovascular disease. Today inAmerica, there are 8,000,000 women living with heart disease.
64 percent of women who die suddenly because of coronary heart disease had no previous symptoms.
Women are the decision makers when it comes to health issues in the home. While we are busy thinking of others, it is important to think about ourselves, too, and to know the facts about heart health.
Studies have shown that women’s symptoms are not usually identified as being related to heart disease. They are often associated with anxiety or other health issues. This is why it is important to be proactive, to know your body and to do your best to live a heart-healthy life.
Another key is to know your family’s history. But even if you don’t have a history of heart disease, you could still be at risk. Pay attention to any unusual symptoms.
Heart attack symptoms
While chest pain is the most common symptom in both men and women, women also report different symptoms from men such as atypical chest pain or shortness of breath, weakness, fatigue, cold sweat and dizziness.
And 78 percent of women reported at least one symptom for more than one month before their heart attack. In one study of more than 500 women who had an acute heart attack, the most frequently reported symptoms were unusual fatigue, sleep disturbances, shortness of breath, indigestion and anxiety. Just 30 percent reported chest discomfort, which was described as an aching, tightness, pressure, sharpness, burning, fullness or tingling.
One Patient’s Experience
In a recent Cleveland Clinic web chat, a female patient relayed a story to cardiologist Leslie Cho, MD, about going to the ER with shortness of breath and chest pains. She was sent home after a “fairly normal” EKG, but thankfully went back to the ER where they tested her blood to find she was on the verge of a heart attack.
She told Dr. Cho: “I think that we need to really be assertive and know [our bodies] and make sure that they test you when you have chest pain—I could have stayed home the second time but felt like something was wrong and I was persistent.”
Says Dr. Cho, “Good for her for being proactive. Yes—women do sometimes have unusual symptoms. That is the reason why educational efforts are being made for patients as well as physicians to look for atypical symptoms in women.”
We always associate chest pain with heart attacks, and for good reason, but it’s not the whole story — especially for women. While chest pain is the most common symptom of a heart attack, women can have symptoms that aren’t related to chest pain at all. They need to be on the lookout for other, subtler symptoms.
Also, we need to dig deeper into the symptom of chest pain for both men and women as it relates to heart attacks. It is seldom as dramatic as you might think, and it can feel like pressure or heart burn that comes on over time.
Below, find three symptoms you should watch for, including information about how to tell if they are benign or cause for concern.
Like many women, you’re probably busy most of the time. You may take care of a family, run a household, work outside the home and care for aging parents. You are probably also tired a lot of the time. Most likely this is normal.
But you should pay attention to fatigue if it is new or dramatic. Here’s what to watch out for:
You are suddenly worn out after your typical exercise routine.
You aren’t exerting yourself, but have fatigue or a “heavy” chest.
Simple activity like making the bed, walking to the bathroom or shopping makes you excessively tired.
Although you feel exceptionally tired, you also experience sleep disturbance.
2. Sweating and/or shortness of breath
As women age, a lack of exercise and gradual weight gain cause issues like shortness of breath. Hot flashes are a common complaint for many women during menopause.
But these symptoms can signal a heart problem when they happen in certain situations:
Sudden sweating or shortness of breath without exertion
Breathlessness that continues to worsen over time after exertion
Shortness of breath that worsens when lying down and improves when propping up
“Stress” sweat (cold, clammy feeling) when there is no real cause for stress
Sweating or shortness of breath accompanied by other symptoms such as chest pain or fatigue
3. Neck, jaw, back pain
As intricate as our body’s systems are, they are very adept at giving signals when there is something wrong. When there is a problem with the heart, it triggers nerves in that area, but you sometimes feel pain elsewhere.
Pain in the jaw, back or arms may signal a heart condition, especially if the origin is hard to pinpoint (for example there is no specific muscle or joint that aches). Also, if the discomfort begins or worsens when you are exerting yourself, and then stops when you quit exercising, you should get it checked out.
Here are some other signs to look out for:
Women, in particular, can have pain in either arm — not just the left one like many men.
Pain in the lower or upper back often starts in the chest and spreads to these areas.
The pain is sometimes sudden, not due to physical exertion, and can wake you up at night.
You may feel pain that is specific to the left, lower side of the jaw.
Women often say they noticed some of these three warning signs weeks or a month before a heart attack.
The sooner you report a problem, the better the chances are of catching an issue before it becomes a full-blown heart attack. If you experience any of these symptoms, take note and visit your doctor as quickly as possible.
When you see your doctor:
Bring a list of your symptoms and when they are occurring.
Let him or her know about any related family history.
Talk about stress or anything going on in your life that might contribute to a problem.
Your doctor likely will listen to your symptoms and check your pulse and blood pressure. He or she may order blood work, which will show whether your heart is damaged.
Your doctor also may use an electrocardiogram (EKG) to tell whether the electrical activity of your heart is normal, or an echocardiogram to view images of the heart to see if damage has occurred.
All this is important in identifying any problems and taking steps to intervene before a possible heart attack.
When to call 9-1-1
Get help right away if you have chest pain or discomfort along with any of these symptoms, especially if they last longer than five minutes:
Pain or discomfort in other areas of the upper body, including the arms, left shoulder, back, neck, jaw, or stomach
Difficulty breathing or shortness of breath
Sweating or “cold sweat”
Fullness, indigestion, or choking feeling (may feel like heartburn)
Nausea or vomiting
Light-headedness, dizziness, extreme weakness or anxiety
Rapid or irregular heart beats
The terms “heart attack” and “cardiac arrest” often are used interchangeably, but they are not the same. While it’s true that having a heart attack may cause cardiac arrest, many times these occurrences happen independently of each other.
One way to explain the difference is that one is a plumbing problem, while the other is an electrical problem.
Heart attack: What happens
A network of blood vessels called coronary arteries surround the heart and supply it with oxygen-rich blood. The heart needs this oxygen to function. A heart attack occurs when a coronary artery becomes blocked, which stops the flow of blood to the heart, says preventive cardiologist Viviana Navas, MD. All or part of the heart muscle becomes cut off from its oxygen supply.
Less frequently, a heart attack also can occur by a spasm of a coronary artery, Dr. Navas says. During coronary spasm, the coronary arteries constrict on and off, which causes a lack of blood supply to the heart. A coronary spasm may occur at rest and can even happen in people without significant coronary artery disease, Dr. Navas says. If coronary artery spasm occurs for a long period of time, a heart attack can occur.
A heart attack damages your heart because of the compromise in blood flow stemming from a blocked or spasming blood vessel, Dr. Navas says.
Signs and symptoms of heart attack
Here are the most common symptoms of a heart attack, according to preventive cardiologist Haitham Ahmed, MD, MPH:
Pain or pressure in the chest or abdomen
Feelings of chest tightness
Pain that radiates to the jaw or arm
Loss of consciousness
Up to a third of heart attack patients do not experience chest pain with heart attacks, Dr. Ahmed says.
Women, in particular, are more likely to have atypical symptoms, Dr. Navas says. Symptoms women experience may include:
Pain that radiates to the arm
Trouble breathing without chest pain
Loss of consciousness
“It’s important to note that just like no two people are the same, no two heart attacks are the same,” Dr. Navas says.
“Even for someone who has already had a heart attack, symptoms of another attack may sometimes be very different,” she says.
Cardiac arrest: What happens
When you suffer cardiac arrest, your heart stops working properly because its electrical system malfunctions. The heart beats dangerously fast. The heart’s two large chambers may flutter or quiver, and blood is not delivered throughout the body. This leads to a rapid drop in blood pressure and collapse of the circulatory system, Dr. Navas says.
In the first few minutes of cardiac arrest, the greatest concern is that blood flow to the brain is reduced so drastically that a person will lose consciousness, Dr. Ahmed says. Death follows unless emergency treatment is begun immediately.
When a heart attack damages or weakens a significant amount of heart muscle, this sometimes leads to electrical disturbances that put the heart more at risk for cardiac arrest, Dr. Ahmed says.
Signs and symptoms of cardiac arrest
Symptoms of cardiac arrest may include:
Blue discoloration of the face
“Some people experiencing cardiac arrest may feel their heart racing or they may feel dizzy,” Dr. Ahmed says. However, more than half of those who undergo cardiac arrest experience no symptoms.
Fevers can be a very scary thing for parents, particularly for first-time moms and dads. Every child will eventually experience a fever, no matter how careful you are.
It is important for parents to know what to do when this happens. First, some tips on measuring your child’s temperature:
A variety of thermometers are available, from standard oral thermometers to the newer temporal artery scanners. You can use any of these devices, but a digital thermometer is generally all you need.
It is most accurate to use a rectal thermometer for infants and young children. If you feel uneasy doing this, use whichever device makes you most comfortable. In older children, an oral temperature is most accurate, if the child is able to tolerate it.
When to keep your cool
So what is a fever? We define a fever as a temperature over 100.4 F (38.0 C). Normal body temperature is 98.6 F (37 C). Everyone’s body temperature varies throughout the day and can differ by age, activity level and other factors. Don’t be alarmed if your child’s temperature varies. The magic number for fever is 100.4 F.
When should you not worry about your child’s fever? We tend not to worry about:
Fevers of less than five days if your child’s behavior is relatively normal. You don’t need to be concerned if your child continues to be playful and is eating and drinking normally. (He or she may seem more tired than usual).
Temperatures of up to 102.5 F if your child is 3 months to 3 years of age, or up to 103 F if your child is older. These temperatures can be common, but not necessarily worrisome.
Low-grade fevers if your infant or child was recently immunized. These can be normal if they last less than 48 hours.
When to call your doctor
Now for the important question: When should you be worried about a fever? Call a doctor when:
An infant younger than 3 months of age develops a fever. Fevers may be your infant’s only response to a serious illness.
Your child’s fever lasts more than five days. We may need to investigate further for underlying causes.
Your child’s fever is higher than 104 F(> 40 C).
Your child’s fever does not come down with fever reducers.
Your child is not acting himself or herself, is difficult to arouse, or is not taking in enough liquids. Babies who are not wetting at least four diapers per day and older children who are not urinating every eight to 12 hours may become dangerously dehydrated.
Your child was recently immunized and has a temperature above 102º F or a fever for more than 48 hours.
You are concerned. If you are uncomfortable with your child’s temperature or illness, call your doctor or nurse practitioner to discuss it.
What to do if a seizure occurs
Seizures are a very scary side effect of fevers in some children. “Febrile seizures” occur in 2 to 4 percent of all children under age 5. Not all seizures cause jerking movements in the body. Some seizures look like “passing out.” If your child develops a seizure:
Put your child on his or her side.
Do NOT put anything in your child’s mouth.
Call 911 if the seizure lasts more than five minutes.
If the seizure lasts less than five minutes, call your physician or seek immediate medical attention.
What to do about multiple fevers
If your child has persistent or multiple episodes of fever and a pediatrician cannot figure out what is causing them, he or she may refer your child to a specialist. A pediatric infectious disease expert or pediatric rheumatologist may be able to get to the bottom of the issue.
Does your mouth have the taste of old pennies? The condition is more common than you might think.
A metallic taste can indicate serious illness, such as kidney or liver problems, undiagnosed diabetes or certain cancers. But these reasons are not common and usually are accompanied by other symptoms.
If you are otherwise healthy, the cause for that metallic tang typically is benign, says family medicine physician Michael Rabovsky, MD. Dr. Rabovsky is Chairman of the Department of Family Medicine and the Vice Chairman of the Medicine Institute at the Cleveland Clinic.
If a metallic taste in your mouth is your only complaint, the cause might be one of several, including prescription drugs or a medical condition. Here, according to Dr. Rabovsky, are eight causes of a metallic taste in your mouth.
Poor oral hygiene – If you don’t brush and floss regularly, the result can be teeth and gum problems such as gingivitis, periodontitis and tooth infection. These infections can be cleared up with a prescription from your dentist. The metal taste typically goes away after the infection is gone.
Prescription drugs – These medicines include antibiotics such as tetracycline; the gout medicine allopurinol; lithium, which is used to treat certain psychiatric conditions; and some cardiac medications. Your body absorbs the medicine and it comes out in the saliva. Also, medicines that can cause a dry mouth, such as antidepressants, can be a culprit. These can affect your taste because they close your taste buds.
Over-the-counter vitamins or medicines – Multivitamins with heavy metals (such as copper, zinc or chromium) or cold remedies (such as zinc lozenges) can cause a metallic taste. So can prenatal vitamins, and iron or calcium supplements. Usually the taste will go away as your body processes the vitamins or medicine. If not, check your dosage and make sure you are not taking too much.
Infections – Upper respiratory infections, colds and sinusitis change your sense of taste. This is temporary and usually ends when the infection does.
Pregnancy – During the early stages of pregnancy, some women find that their sense of taste changes. One of those changes may be a metallic taste.
Dementia – People with dementia often have taste abnormalities. The taste buds are connected by nerves to the brain. Taste abnormalities can occur when the portion of the brain related to taste is not working properly.
Chemical exposures – If you are exposed to mercury or lead, inhaling high levels of these substances often can produce a metallic taste.
Dr. Rabovsky says that if you experience a metallic taste, it’s best to talk with your doctor, who can then determine if you have a serious illness or condition.
Some types of chest pain should send you to the emergency room immediately.
If you experience pain, pressure or discomfort in the center of your chest or in your arms, back, jaw, neck or stomach — along with shortness of breath, a cold sweat, nausea, fatigue or lightheadedness — for at least five minutes, call 9-1-1.
But when chest aches and pains are fleeting, it’s often something different.
Symptoms that suggest another problem
As Cleveland Clinic cardiologist Curtis Rimmerman, MD, writes in his book “The Cleveland Clinic Guide to Heart Attacks, the following symptoms are unlikely to signal a heart attack:
Momentary chest discomfort, often characterized as a lightning bolt or electrical shock. Heart discomfort or pain is unrelenting, typically for several minutes. Momentary chest discomfort is more likely to result from musculoskeletal injury or inflammation, or nerve pain (e.g., a cracked rib, a pulled muscle in the chest wall or shingles involving the chest.)
Pinpoint chest discomfort that worsens with positional changes in breathing. Heart pain is usually diffuse, or radiating. Pinpoint discomfort that changes with breathing is more likely to involve the lungs (e.g., pleurisy, an inflammation of the lung membranes; pneumonia; or asthma).
Chest discomfort that gets better with exercise. Heart-related pain typically worsens with exercise. Sharp chest pain that improves with movement is more likely to have other causes (e.g., acid reflux.)
Heart attack symptoms vary widely
Dr. Rimmerman emphasizes that the symptoms of heart attack or angina can vary greatly from person to person. Some people experience no symptoms at all. Others experience crushing chest pain. Still others may feel only arm discomfort.
“Regardless of the site of the discomfort, people typically can’t find a position that relieves the pain,” writes Dr. Rimmerman. “Nor do they find relief by ingesting liquids, popping antacids, or taking deep breaths.”
Heart attack discomfort is unrelenting, typically lasting five minutes or more (up to half an hour or, rarely, two hours). That’s when it’s important to call 9-1-1 to get emergency treatment.
If chest discomfort is fleeting but severe, make an appointment to see your primary care doctor.
But when in doubt, Dr. Rimmerman advises, “Err on the side of caution, and visit a doctor or emergency room.”
If you’ve been to a doctor, looked at medical websites or watched a daytime talk show, you’ve probably heard the three magic letters BMI.
BMI, or body mass index, is the most basic tool doctors use to check your body composition and predict your risk of disease. There are plenty of online BMI calculators that will do the math for you,but it turns out there is a better tool at your disposal: waist-to-height ratio. Best of all, just like BMI, you can measure it yourself.
DIY disease predictor
All you need to measure BMI is your height and weight — plus a calculator or good head for math. All you need to measure your waist-to-height ratio is your waist size and height. A tape measure will do the trick.
“All you need to measure your waist-to-height ratio is your waist size and height. A tape measure will do the trick.”
But waist-to-height ratio isn’t just simpler; it’s also better. Researcher Margaret Ashwell made the case for this measurement last year after studying the health of 300,000 patients. She found that waist-to-height ratio is better than BMI at predicting diabetes, hypertension, heart attacks and strokes.
BMI doesn’t take into account lean body mass versus body fat, so a very muscular person could end up classified as overweight and at-risk. Waist-to-height ratio does a better job of avoiding that problem by including the waist, where abdominal fat lives. Abdominal fat seems to be the worst kind when it comes to disease risk.
How to measure
To be healthy, your waist circumference should be less than half of your height. For example, if you are a 5-foot (60 inches) female, your waist circumference should be 30 inches or smaller. Keeping that ideal ratio will reduce your risk of disease — and increase your life expectancy.
To get an accurate waist measurement, don’t just measure where your pants sit — and avoid the urge to suck in your gut like you’re in a photo. Instead, relax, and start the tape measure just above one of your hip bones and below your lowest rib, keep it level at the belly button all the way around. You want the tape measure to be snug, but not compressing your body.
If the measurement is more than half of your height, use that as motivation. You can make smart choices, lose that harmful abdominal fat and give yourself a longer, healthier life in the process.
When it comes to your health, there are some numbers you should know by heart. Discover if your numbers are where they should be, and get tips for disease prevention and heart-healthy living in these infographics:
About 30 percent of U.S. adults have high blood pressure – roughly 76 million Americans. It’s one of the most common diseases, but there’s still a lack of understanding about the disease.
It’s important to diagnose and treat high blood pressure, which is also known as hypertension. It increases the risk of heart attack, stroke, heart failure, kidney failure and death.
First and foremost, the optimal blood pressure is less than 120/80 mmHg. The top number is the systolic blood pressure, and the bottom number is the diastolic blood pressure. Pre-hypertension is systolic blood pressure 120 to 139 mmHg or diastolic blood pressure 80 to 89 mmHg.
Hypertension is diagnosed when your blood pressure is greater than 140/90 on two or more office visits after an initial screening.
However, in the European guidelines, diagnosis of hypertension is made using either ambulatory blood pressure monitoring or home blood pressure monitoring.
This approach is especially helpful for patients who have what’s called “white coat” hypertension. Some patients get very nervous, excited or agitated in the doctor’s office, and their blood pressure tends to be high. However, at home, their blood pressure may be completely normal. These patients are good candidates for home monitoring.
The risk factors for hypertension are age, obesity, a diet high in salt, alcohol, a sedentary lifestyle, personality traits, race and family history.
There are other important causes, too, such as over-the-counter nonsteroidal anti-inflammatories (like those sold under the brand names Naprosyn, Alleve and Advil), decongestants, weight-loss medications, birth control pills and chronic pain that can increase blood pressure. Another common cause is untreated or undiagnosed sleep apnea.
Natural ways to lower blood pressure
If you were diagnosed with high blood pressure, what can you do to lower it naturally? Diet and exercise are key, as well as eliminating things that may be increasing your blood pressure.
That’s right: Exercise, diet and losing weight can truly lower your blood pressure. Pills are supplements, not a substitute for treating high blood pressure.
Most people only need 1,500 mg of sodium a day. Did you know there are 2,300 mg of salt in one teaspoon?
Before you add salt to your meal, think about that. The average American’s diet has 3,400 mg of sodium a day! People with blood pressure issues should ideally get around 2,000 mg a day.
A good diet to follow to lower your blood pressure is the DASH diet, which stands for Dietary Approaches to Stop Hypertension. It’s an eating plan that emphasizes vegetables, fruit and low-fat dairy, as well as whole grains, fish and reduced amounts of fat and red meat.
If you want to make an impact on your blood pressure, you also have to become a label reader.
Remember to read serving size. Ignore the percent daily value, and focus on the amount of sodium per serving.
Also, reduced sodium just means it’s 25 percent less sodium than the comparable food product.
In general, use fresh and frozen ingredients, and choose low-sodium soups, meats, cheese and condiments — ketchup has a lot of salt! Bread, too, has a lot of sodium, so be careful.
There are numerous salt-free seasonings, such as basil, cinnamon, chili powder, cumin, dill, ginger, marjoram, nutmeg, oregano, parsley, rosemary, sage, thyme and tumeric. Use those if you can.
Finally, please exercise. Losing weight and exercising consistently can lower your blood pressure by 5 to 10 mmHg.
Aim for 75 minutes of vigorous exercise a week or 150 minutes of moderate exercise a week to see a benefit. Find what you like to do, and do it consistently.
There is no magic exercise; focus on what you like to do and don’t mind doing most days of the week.
This post is based on oneof a series of articles produced by U.S. News & World Report in association with the medical experts at Cleveland Clinic.
Plans for dieting frequently top the list of New Year’s resolutions. Recently, U.S. News & World Report ranked the top diets of 2012, which could make planning meals and managing heart health a bit easier.
Best overall diet: DASH diet
The DASH diet topped the list for 2012, with the diet showing as heart healthy and nutritionally sound. The diet focuses on fruits, vegetables, whole grains and lean proteins, while cutting back on heavy calorie foods. It also limits salt. The Dietary Approaches to Stop Hypertension (DASH) diet aims to prevent and lower high blood pressure.
“I encourage patients with hypertension or pre-hypertension to follow the DASH diet, but it is excellent for any adult to follow in order to keep within the recommended sodium limit of 2,300 milligrams or less per day and prevent hypertension,” says Cleveland Clinic Preventive Cardiology dietitian Kate Patton, MEd, RD, CSSD, LD.
Second overall best: TLC diet
The TLC diet was ranked second overall, as well as second in Best Heart-Health Diets. The TLC diet is recommended by the American Heart Association and aims to reduce “bad” LDL cholesterol by cutting back on saturated fat, limiting daily dietary cholesterol intake and getting more fiber.
“I completely agree that the DASH diet and TLC diet are two excellent diets. I think they are great because they are not really a ‘typical’ diet, yet describe how to follow a healthy, balanced diet,” Patton says. The TLC diet is also appropriate to follow for anyone with high cholesterol, but it would not hurt to follow it to prevent hyperlipidemia – or high blood cholesterol levels.
Best diet for heart health: Ornish diet
The TLC diet came in second to the Ornish diet for Best Heart-Healthy Diets. While the Ornish diet is fairly restrictive, it can be used for a multitude of benefits in addition to preventing and reversing heart disease such as losing weight, lowering blood pressure and cholesterol, and preventing and treating prostate or breast cancer.
The guidelines for this diet state no more than 10 percent of calories from fat, which is found naturally in foods, but not from added fats; no more than 10 milligrams cholesterol; no animal products-meat, poultry, fish, eggs, cheese, except for two servings fat free dairy and egg whites; no more than 2 tablespoons (24 grams) of added sugar; no caffeine, except for green tea. If you are interested in following a vegetarian diet to improve your heart health, the Ornish could be a great diet for you.
Honorable mention: Mediterranean diet
Though the Mediterranean diet came in third, it ranked with four out of five stars for heart health and Patton says it’s a good well-balanced diet. “It encourages more fish and legumes, which most Americans do not eat as often as red meat and poultry,” Patton says. Replacing fish and legumes for red meat and poultry reduces intake of saturated fat and increases intake of heart healthy omega-3 fats and cholesterol lowering soluble fiber.
No diet is a one-size fits all approach. Cleveland Clinic dietitians will work with each patient to find a diet that safely fits their lifestyle and health goals.