When Katherine Fitzgerald suddenly started vomiting, sweating profusely, and experiencing chest pain and tingling in her right elbow, paramedics told the 57-year-old that she was having a panic attack and did not need emergency treatment. While her 18-year-old son wanted her to go to the hospital, the paramedics insisted Fitzgerald calm down, go home, and rest.
Two days later, her chest still ached. At the request of her son, she went to the hospital. It turned out she wasn’t having a panic attack after all. Fitzgerald had had a heart attack, and needed two stents to clear blocked arteries.
“Looking back, I wonder if had I been a man, if paramedics would’ve taken me to the hospital right away and treatment would have started sooner,” says Fitzgerald, who is now 60.
Even after the stents, Fitzgerald still wasn’t feeling well. She wanted a new doctor, someone who better understood the science of women and heart attacks. She found cardiologist Harmony R. Reynolds, MD, director of NYU Langone’s Sarah Ross Soter Center for Women’s Cardiovascular Research and an internationally renowned expert on heart disease syndromes that primary affect women. Her research is focused on understanding what makes heart attacks in women different and the best methods for detection and treatment.
“I really made an effort to listen to Katherine because I knew she had a history of being ignored and misdiagnosed. Patients, especially women, benefit from receiving care in a place where their cardiologist considers all aspects of their condition.”
—Harmony R. Reynolds, MD
“I really made an effort to listen to Katherine because I knew she had a history of being ignored and misdiagnosed,” says Dr. Reynolds. “Patients, especially women, benefit from receiving care in a place where their cardiologist considers all aspects of their condition.”
Dr. Reynolds’s research shows that Fitzgerald is not alone in her experience. She published a study in the Journal of the American Heart Association that found that women experiencing chest pain wait 11 minutes longer to get care in the emergency department than men with the same symptoms.
This delay can lead to worse outcomes. “Time is heart muscle,” says Dr. Reynolds.
A New Diagnosis: Coronary Artery Spasm
Dr. Reynolds conducted a thorough chest pain evaluation, finding that Fitzgerald’s chest discomfort was caused by muscle spasms in the coronary artery walls in addition to plaque buildup.
“Cardiac pain is often due to plaque buildup in the arteries, but in women, more than in men, there are additional contributing factors like coronary artery spasm and disease of the small arteries, called coronary microvascular disease,” says Dr. Reynolds. She prescribed medications, including calcium channel blockers and nitrates, which relax the blood vessels, to alleviate Fitzgerald’s chest discomfort. Fitzgerald also received another stent to open a blocked artery.
NYU Langone Heart offers comprehensive chest pain diagnostics, including testing dedicated to the small heart arteries and provocation testing, in which real-time imaging reveals how blood vessels respond to medication injected into the bloodstream. This test is available at NYU Langone and only a few other medical centers in the country.
Dr. Reynolds also recommended steps to reduce stress, a key component to heart health. Fitzgerald works on legal cases at her desk instead of going to court and has adopted a less intense exercise routine. “I’m starting to enjoy my life again,” she says. “If I take care of myself, I will have a nice healthy life ahead of me.”
Heart Attack Symptoms in Women
Like many women, Fitzgerald’s heart attack symptoms went beyond the typical crushing chest pain often depicted in popular culture. Women are more likely to describe their pain as discomfort, pressure, burning, aching, or some other sensation. “Some women may say their bra is too tight or they feel like they have a belt around their chest,” says Dr. Reynolds.
Other heart attack symptoms commonly experienced by women include the following:
- discomfort in the jawline, neck, upper stomach, either arm, or back
- shortness of breath
- nausea and vomiting
- extreme fatigue
- an overall sense that something is wrong
These symptoms can happen along with chest discomfort, or even without chest discomfort.
“If you’re experiencing symptoms, don’t hesitate to speak up. Go to the emergency department, and tell healthcare providers that you think you’re having a heart attack for immediate diagnosis and treatment,” says Dr. Reynolds.
More About NYU Langone Heart
NYU Langone is among the top 5 hospitals in the country for cardiology and heart surgery, according to U.S. News & World Report’s “Best Hospitals.” Make an appointment with one of our cardiologists or cardiac surgeons.