The Heart of the Matter

Know your risk factors and the warning signs of heart disease.
When Cindy DeMarco had a heart attack, she was a fit 30-year-old training for the Marine Corps Marathon who had just received a perfect score on her military fitness test. Now 35, the FBI lawyer urges all women to recognize what statistically is their greatest health risk. "Before I had a heart attack, I thought it was a man's disease."


Now she knows heart disease kills more women in the United States than any other disease, accounting for about 500,000 deaths annually. It cuts short the lives of more women each year than does breast cancer, osteoporosis, AIDS and domestic violence combined. In fact, more women than men die from heart disease.

Women aren't the only ones underestimating the threat. In 1995, only two-thirds of physicians surveyed knew that heart disease was the primary killer of women, explaining why many physicians fail to teach women the warning signs and dangers of heart disease. Many emergency room workers also miss the signs and symptoms in women. That's what DeMarco discovered when she finally sought help.

She planned to sleep in on a Saturday morning in June 2000, but instead awoke with a start around 7 a.m. "I had a severe, crushing pain in my chest and pain in my upper back. I couldn't take a breath." She was dizzy, nauseous and in a cold sweat. She wondered if she had food poisoning. Later in the day, she felt tingling in her jaw and arm. After toughing it out for nearly 12 hours, DeMarco went to the emergency room.

When she described her symptoms to the ER doctor, he wasn't too concerned, wanting to send her home with muscle relaxants. But DeMarco felt a "sense of doom" and urged him to give her an EKG test (electrocardiogram, used to measure heart activity). Reluctantly, he did. It showed she was having a heart attack.

DeMarco was lucky. Women are less likely than men to survive a heart attack. Part of the problem is a delayed diagnosis because women have less outpatient work-up, says cardiologist Debra R. Judelson, director of the Women's Heart Institute, part of the Cardiovascular Medical Group of Southern California in Beverly Hills. It's also partly because women are less likely to go to the hospital as many fear embarrassment or deny their symptoms.

Know your risks

Heart disease is often a silent threat. Two-thirds of women and one-half of men who die of heart disease had no prior symptoms, according to Judelson. "It's not something you can feel or see in a mirror."

So being proactive is important. Know your risks and discuss them with your doctor. "You need to go to the doctor. You need to know what's going on inside your body," says Judelson.

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