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People say, "You don't know what you don't know." But the American Heart Association does. While many of us claim to be aware that heart disease is the number one killer of Americans, only 56% of women realize it's such a significant menace. What's more, we often aren't familiar with the condition's risk factors (from carrying around excess pounds to having an autoimmune disease like rheumatoid arthritis). Or the fact that heart disease can strike without any previous symptoms. But knowledge—like the details shared by the following four women who brought their hearts back from the brink—can help you protect the most important muscle in your body.
NEFERTARI A. NELSON, 42
WILLINGBORO, NEW JERSEY
If she could travel back in time to a scary night nearly eight years ago, Nefertari would change one thing: She'd go to a different hospital. "Women should know which hospital closest to their home has the best cardiac unit," says Nefertari. "That wasn't my first stop."
That night, while nine months pregnant with her fifth child, Nefertari began to feel tremendous pressure on her chest. A tear had formed in one of the vessels carrying blood to her heart. The emergency condition, called SCAD (spontaneous coronary artery dissection), was followed by hours of agonizing pain. What's more, it led to a heart attack and cardiomyopathy, a disorder that occurs when your heart muscle becomes enlarged and rigid. The morning after she arrived at the first hospital, a cardiologist saw her and then sent her by helicopter to the Hospital of the University of Pennsylvania, where she delivered her baby, was given meds to stabilize her heart function, and had her coronary artery repaired with stents. Doctors later implanted a defibrillator in her chest to normalize her heart rhythm and prevent sudden cardiac arrest.
Experts aren't sure what causes SCAD, but research shows 80% of those affected are female, the average age of onset is 42 and one-fifth of cases occur in the days before and after childbirth. Extreme physical exertion and high levels of emotional stress are also associated with the condition. Once symptoms (such as pain in your chest, arm, shoulder or jaw; rapid heartbeat; shortness of breath) begin, it's critical to get to a hospital quickly.
Nefertari's baby is now 7 years old and doing well. And so is she. Although her health status is considered critical but stable, the dating website producer and jewelry maker is able to engage in many everyday activities like driving and gentle yoga. Most important, she can take good care of her children—all of whom she's had screened for heart disease.
A doctor weighs in: "Mortality from heart disease in women 35 to 54 has been increasing in the past few years." —Michael S. Fenster, MD, author of The Fallacy of the Calorie
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HILORY WAGNER, 51
A roller-coaster ride. Falling in love. Plenty of fun things can make your heart skip a beat. So for years, Hilory didn't think much of having that feeling now and then. However, in March 2011, she began to sense heart palpitations all the time. "It was hard to breathe," says the communications manager and mom of two. "I was lightheaded and always exhausted."
Hilory made an appointment with her doctor and after an EKG, she was diagnosed with premature ventricular contractions (PVCs), a condition in which extra beats disrupt the heart's regular rhythm. Wearing a 24-hour monitor revealed that Hilory's heart was actually clocking an extra 15,000 beats per day.
It took work—trying different medications and finding the right MD (an arrhythmia specialist)—to put Hilory's heart at ease. The specialist suggested cardiac ablation, a procedure that destroys the tissue in the heart responsible for triggering an abnormal rhythm. Hilory had the procedure four months after her symptoms had become extreme and ongoing, and the PVCs stopped that day. "I had to see a lot of doctors and be proactive to get the treatment that fixed me," says Hilory, who once went to the ER convinced her heart was about to stop. "Persistence is difficult when you feel so sick, but it's essential."
A doctor weighs in: "If you experience PVCs, ask an arrhythmia specialist whether the condition could run in your family so you can warn relatives." —Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women's Health at NYC Langone Medical Center
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DIANE HARRINGTON, 52
Four years ago, while on vacation in Michigan, Diane was reading a book on her iPhone. As she swiped to turn the page, she suddenly felt as if someone were squeezing the inside of her elbow. The pressure became more intense and she started to sweat. Diane recognized the signs: This was a heart attack. "I knew what was happening but didn't want to speak up because my 13-year-old son was there and I didn't want to scare him," she says.
After a few minutes she signaled to her husband and explained what was wrong. Remembering something he'd read, he ran to get her a couple of baby aspirin to chew on. (This can slow the blood's clotting action and improve the outcome if someone is having a heart attack, but always call 911 before taking it.) A friend drove them to the local hospital. Doctors attempted balloon angioplasty, in which a tiny balloon is guided into a blocked artery, inflated to compress plaque, deflated, then removed. But a complication during the procedure required her to have a more extensive surgery than anticipated. While Diane has felt good for the past few years, she admits she's struggled to exercise and eat right. "I make an effort to grab the carrots instead of the potato chips," she says, but because her 19-year-old son and her husband like junk food, it's always around, tempting her. Experts suggest a health coach could empower her to improve her lifestyle.
"A good one can help you understand and reduce self-destructive habits as well as set and accomplish goals," says cardiologist Cynthia Thaik, MD, author of Your Vibrant Heart: Restoring Health, Strength & Spirit from the Body's Core. She also strongly recommends that Diane learn stress management tools (like meditation) to help guide her toward lasting positive results.
A doctor weighs in: "Cardiac rehab save lives, improves your functionality and shouldn't be missed." —Joel Kahn, MD, author of The Whole Heart Solution
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SARAH SWEATT ORSBORN, 31
LITTLE ROCK, ARKANSAS
Three days after Sarah gave birth to her twin daughters by C-section, she went into congestive heart failure.
She awoke, terrified, in intensive care with a tube down her throat. The cause was peripartum cardiomyopathy, a disorder that can develop during or soon after pregnancy in which the heart becomes weak and enlarged and can't pump effectively.
Sarah knew she had one of the risk factors for peripartum cardiomyopathy: a pregnancy with multiples. But it wasn't until she had an MRI that she learned a congenital heart defect made her heart pump poorly. It turns out that the flutters Sarah had experienced in her chest throughout her life, along with regular fatigue and an intense preference for reading and writing over exercise, weren't normal—even though they felt normal to her.
"I thought I just fit the profile of the nerdy bookish kid who didn't want to be in P.E.," says Sarah, who also never mentioned her lack of energy to a primary care physician and saw only ob-gyns. But any woman who has unusual symptoms or knows that she has risk factors for heart disease should talk to her PCP.
A combination of rest, medications to regulate heart function and not being pregnant are what helped Sarah recover from her cardiac event. (Pregnancy, especially with multiples, increases blood volume and can be taxing on the cardiovascular system.) Today she also eats a heart-healthy diet that is mostly vegetarian and does Zumba three days a week. "Having children and then coming back from a near-death experience made me want to take better care of myself," says Sarah, who blogs about parenting, politics and spirituality at erniebufflo.com. "Giving my body the healthiest diet I can is the best way to take care of it, since I know my heart works extra hard."
A doctor weighs in: "When we know about cardiac conditions prior to pregnancy, we can better counsel women on their risks and assist the ob-gyn with a delivery strategy." —Kevin R.Campbell, MD, author of Women and Cardiovascular Disease
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A Decade-by-Decade Guide to Guarding Your Heart
IN YOUR 30s Prevention is key. A healthy, plant-rich diet and daily exercise are critical to limiting cardiac risk. Raising children, work and family obligations may make you want to cut back on pillow time to get more done, but sleep is also important to heart health—aim for at least seven hours a night.
IN YOUR 40s Metabolism slows, so watch the size of your waistline and stay on top of your blood sugar, blood pressure, cholesterol levels and inflammatory markers (like C-reactive protein). By the time a woman reaches age 45, her lifetime risk for cardiovascular disease has hit 55%, and black women are at higher risk for death.
IN YOUR 50s When menopause occurs, women must carefully discuss with their doctor the risks and benefits of hormone therapy, taking into consideration their personal and family health histories and lifestyle. If you haven't been exercising, you may need a physical and a stress test first. Some doctors also suggest a calcium heart score by CT scan to see whether heart disease is silently creeping up on you.
IN YOUR 60s AND BEYOND This is when the hard work of prevention pays off. But still be on guard: Women are at their highest risk for developing a common heart rhythm problem called atrial fibrillation, which can lead to heart attack and stroke. No matter what your family and health history, talk to your MD about your risk.
SOURCES: Kevin R. Campbell, MD; Michael S. Fenster, MD; and Joel Kahn, MD