Did you know that women are disadvantaged at every stage of their heart attack experience? From delays in seeking help, to poorer standards of diagnosis, treatment and aftercare, the heart attack gender gap is costing too many females their lives. The British Heart Foundation Cymru cast a light on the improvements that are urgently needed.

Stark inequalities in awareness, diagnosis and treatment of heart attacks are needlessly killing women every day in the UK, according to the British Heart Foundation (BHF).

BHF-funded research estimates that more than 8,000 women in England and Wales died over 10 years because they did not receive equal treatment to men. The BHF says that more lives are at risk as research shows that women delay seeking help when they experience heart attack symptoms.

Women are twice as likely to die of coronary heart disease, the main cause of heart attack, as breast cancer in the UK – yet it is still not always seen as a woman’s problem. The charity want to put an end to the perception that heart attack is a male disease, and are encouraging women to better understand their risk of a heart attack and its symptoms.

Case Study: Mandy’s Story

Mandy Swift, 54 from Rhyl, was 51 when she had her first heart attack but didn’t recognise the symptoms so didn’t seek medical attention. Just three months later in March 2017, when she was 52, Mandy had a second heart attack but because she didn’t know that it was a heart attack, she waited a further week before seeing her GP, who immediately sent her to hospital where she underwent an emergency procedure and had two stents inserted.

Mandy explained, ‘I was living and working in Bulgaria at the time. I was decorating my bedroom and didn’t feel right. I don’t remember much but I know that I had pain in my left arm, starting in my shoulder and right down through my entire arm.

‘The pain I felt in my left arm was a throbbing pain, almost like when you have a toothache, but very painful, and my arm felt heavy. Before the actual heart attacks, I had been feeling tired, moody, had felt some palpitations – nothing too much – but I had attributed this to the menopause because of my age. I don’t actually know if this might have been warning signs; it certainly hadn’t worried me enough to go to the doctor.’

Mandy continued, ‘I went to bed and think I must’ve drifted in and out of consciousness. I thought maybe I’d pulled a muscle from painting the ceiling, but it was more painful than that. I vomited, but I hadn’t really eaten anything so I was just vomiting water. I think I slept on and off for about two days. I was living alone, and afterwards I just carried on with my job and life as normal.

‘About three months later the same thing happened again when I was decorating. This time my experience was more painful and the vomiting went on for longer. Again, I slept for most of the weekend. I just didn’t feel right but it was another week before I went to my GP because I felt my heart was pounding and didn’t feel normal. My GP put me straight on a heart monitor and then rushed me to hospital for an emergency procedure and within two hours I’d had an angioplasty and two stents. I’m now living with heart failure.’

BHF Cymru want to highlight that heart attack is not just a male disease. The nation’s biggest heart charity also want to encourage women to better understand their risk of a heart attack and its symptoms.

Each year around 1,800 women across Wales are admitted to hospital due to a heart attack. BHF Cymru estimate that at least 20,000 women alive in Wales today, like Mandy, have survived a heart attack.

Mandy continued, ‘My whole life has changed since my heart attacks. I’ve had to give up my job and my life in Bulgaria and move back to the UK. I didn’t recognise the symptoms of my heart attacks and didn’t know what was happening to me. I’m now on a lot of medication; I take nine tablets each morning and six each night. I can no longer work because of my condition, I’m very tired a lot of the time, I feel the cold more, and some days I can barely walk.

‘It’s hard adjusting to my condition as I’ve always been busy and active. I had no previous heart issues and there’s no history of heart attacks in my family. I have to learn to live with my heart condition now and to accept what’s happened and make adjustments, but it’s not easy.

‘However, I know that I am very lucky and that it could have been a completely different experience if I delayed treatment any longer. That’s why I’m backing BHF Cymru’s call for more women to better understand their risk of a heart attack and its symptoms.’

Steps Towards Change

Adam Fletcher, Head of BHF Cymru, said, ‘Heart attacks have never been more treatable, yet women are dying needlessly because heart attacks are often seen as a man’s disease, and women don’t receive the same standard of treatment as men.

‘The first steps to closing this gender gap include changing the public perception of women and heart attacks. The assumption that women are not at risk of heart attack is false, and has proven to be deadly.

‘In addition, we need to continue to fund research to better prevent, diagnose and treat heart attacks. We also need to raise national awareness of gender-based inequalities in heart attack care and identify and guard against unconscious biases that could contribute to them.’

BHF Cymru want to empower women to better understand their risk and to know the many symptoms of a heart attack. When someone has a heart attack, every second counts. The sooner that people recognise their symptoms and call 999, the better their chance of recovery.

How Individuals Can Recognise Symptoms of a Heart Attack

The Symptoms of a Heart Attack Vary from Person-to-Person

Not everyone gets ‘classic’ crushing chest pain. The most important thing for individuals is recognising the symptoms – something we know that women are less likely to do.

Women may be less likely to seek medical attention and treatment quickly, despite the warning signs. This can dramatically reduce their chance of survival.

If a person thinks that they are having a heart attack, they should not delay and call 999 for an ambulance immediately.

Rapid treatment is essential, and the aim is to restore blood flow to the affected part of the heart muscle as soon as possible. This helps to limit the amount of damage to the heart.

Signs and Symptoms of a Heart Attack in Women

Heart attack symptoms can vary, but the most common signs of a heart attack are:

• Chest pain or discomfort in their chest that suddenly occurs and doesn’t go away. It may feel like pressure, tightness or squeezing

• The pain may spread to their left or right arm or may spread to their neck, jaw, back or stomach

• They may also feel sick, sweaty, light-headed or short of breath

Other less common symptoms include:

• A sudden feeling of anxiety that can feel similar to a panic attack

• Excessive coughing or wheezing

What Can Women do to Reduce the Risk of Having a Heart Attack?

As individuals get older it is increasingly important to be aware of the risk factors that can affect their risk of developing coronary heart disease:

• High blood pressure

• High cholesterol

• Diabetes

• Smoking

• Being overweight

• Not doing enough physical activity

We recommend that all women over the age of 40 visit their local GP or nurse for a health check to check their cardiovascular risk. Their doctor should invite them to review their risk every five years, but patients can also just make an appointment themselves to check their blood pressure and cholesterol.

This check may help to highlight anything that could put them at increased risk of having a heart attack. Identifying and managing risk factors, such as high blood pressure or high cholesterol, early on could help lower the risk of a heart attack in the future.

If the patient has a family history of heart or circulatory disease, they should tell their doctor or nurse. Individuals are considered to have a family history of heart or circulatory disease if:

• Their father or brother was under the age of 55 when they were diagnosed with a heart or circulatory disease

• Their mother or sister was under the age of 65 when they were diagnosed with a heart or circulatory disease

For more information about the BHF’s campaign, visit www.bhf.org.uk/women.