If you're a woman, you're likely blaming that pain in your chest on lunch, stress or a pulled muscle.
But what if it's your heart?
"Heart disease and stroke are the No. 1 killer of Canadian women," says Ottawa cardiologist Dr. Kathryn Ascah. "Women have to acknowledge when and if there might be a heart issue, because heart attacks can kill whereas a stomach problem like hiatus hernia can't."
Every seven minutes in Canada someone dies from a heart attack or stroke.
"Heart is muscle," says Ascah who is also acting director of the Echocardiography Laboratory at the University of Ottawa Heart Institute. "If you come into the ER and your symptoms turn out not to be cardiac, that's OK. But take it seriously because heart attacks, with what we know now, can be aborted. If you wait it can be too late."
Women often present with angina (discomfort or chest pain that may come and go and occurs when part of the heart muscle isn't receiving adequate oxygen-rich blood), says Ascah, who adds that men more often present with thundering chest pain and acute heart attacks. Pay attention: Angina is often mistaken for indigestion.
Women should make sure their doctors do a full heart history and risk assessment based on family and lifestyle factors such as smoking. Cholesterol levels should be checked, an ECG taken, a fasting blood sugar test done, perhaps even an exercise treadmill test ordered -- especially if there are indications of cardiovascular disease.
Exercise stress tests may result in false positives for women, says Ascah. Women's fluctuating hormones may affect aspects of the stress test. If a stress test throws up a false positive, Ascah recommends a further imaging stress test (using thallium, for instance) to confirm or rule out blockages.
Young women with diabetes have the same coronary risk as men -- even though theoretically women are protected by hormones.
Most Canadian women have at least one risk factor for heart disease and stroke. Women are their family's caregivers -- but you can't help anyone unless you help yourself first.
