When we picture someone having a heart attack, we often associate it with a middle-aged, slightly older white man who smokes and has a poor diet.

But victims and researchers are calling on the public and medical professionals to recognise a ‘heart attack gender gap’ exists and are raising awareness that women can suffer them too.

Marie Louise, who is from Watford, spoke to Metro.co.uk about her experience of having a heart attack – when even paramedics couldn’t work out what was happening to her.

The now 37-year-old said she was at work two years ago making a cup of tea when she started to feel like something was wrong.

‘I started feeling really hot,’ said Marie, who is a senior project manager.

‘I thought maybe it’s indigestion or something, but I had only eaten a soft muffin so it couldn’t be that. I drank the tea a bit more, thinking it might help.

‘But the pain was so shocking in my chest then the pain went along my right arm and went really, really hot. I felt really dizzy.

‘In my manager’s office I was in tears and said to call an ambulance.  

‘I ran out of his office and had to throw up and the pain was getting worse and I was getting hotter and hotter.’

‘I could barely walk’

Paramedics arrived and did some checks including an ECG – but no immediate issues were apparent. They told Marie it wasn’t mandatory for her to go to hospital, but she decided to as she felt so unwell.

‘I was feeling awful – I could barely walk,’ she explained, ‘At this point no one knew I had suffered a heart attack.

At Paddington Hospital Marie underwent a number of tests – and it was revealed she’d had a heart attack.

The cause of this was found to be spontaneous coronary artery dissection (SCAD), where a tear appears in an artery wall. The condition is more common in women.

‘Suddenly I wasn’t allowed to walk anywhere, they wheeled me around,’ she said.

‘At that point, everything changed, people became more serious around me as they realised what had happened to me.’

She spent 10 days in hospital and had a stent inserted, and was put on medication.

Marie said when she first came out of hospital she was still unwell – suffering with migraines and headaches as a result of the medication, and she had bruises from where she was operated on.

‘In a way, it’s like you’ve almost died and now you’re trying to build yourself back up again,’ she said.

‘Your skin peeling off, not feeling or looking like you. I couldn’t walk far, but I just wanted to get outside and breathe in the fresh air.

‘The positive thing is that I survived it. Life is different now because I have to take tablets and I get a bit more tired now.’

Knowing the warning signs

She said she is speaking out about her story to raise more awareness of heart attacks in women – particularly BAME women – and of SCAD.

‘There are some warning signs but if you don’t know then you won’t pick up on them,’ she said, ‘The doctors asked if I felt any symptoms leading up to it.

‘I didn’t think I did when I first thought about it, but looking back I probably did some signs – slightly raised blood pressure. I did have some tingling in my legs and fingers, and I did have some pains in my chest sometimes.

‘I thought it was just a cold.’

What is spontaneous coronary artery dissection (SCAD)?

According to the British Heart Foundation website, spontaneous coronary artery dissection (SCAD) is when a tear appears in the wall of a coronary artery, which supplies blood to your heart. In some cases, this can lead to a heart attack or cardiac arrest.

Your coronary arteries are made up of three layers. SCAD happens when one or more of the inner layers of a coronary artery tears away from the outer layer. Blood is able to flow into the space between the layers and a blood clot forms, reducing the flow of blood through the artery. 

SCAD is a rare heart condition that occurs suddenly with no apparent warning. It is most common in women under the age of 50. The condition can’t currently be predicted or prevented. 

Those with SCAD are generally healthy. They often don’t smoke or have diabetes and aren’t usually overweight or obese, which are usually the risk factors which can increase your chance of having a heart attack. This means that the condition is often misdiagnosed or there is a delay in diagnosis.

The symptoms are very similar to those of angina – chest pain or discomfort – or a heart attack. 

You may feel a heaviness or tightness in your chest. This may spread to your arms, neck, jaw, back or stomach. You may also feel short of breath, sick, sweaty and light headed.

She said people have been ‘stunned’ to hear of her ordeal because she is young and healthy. She said her grandma died of a heart attack, but doctors had never suggested she was Marie was at risk of having one too.

‘When people look at me they’ve got no clue about my condition,’ she added.

‘I maintain a healthy lifestyle and good diet, and I like to encourage others who have gone through something similar. I could have died.’

The ‘heart attack gender gap’

Professor Chris P. Gale, who is a consultant cardiologist and works in cardiovascular medicine in Leeds, told Metro.co.uk about how he was funded by the British Heart Foundation (BHF) to investigate the ‘heart attack gender gap’ between men and women.

‘We found women tend to be less well treated and have higher mortality rates,’ he said. ‘And this is even happening in countries which treat heart attacks really well, like the UK and Sweden.’

He suggested there may be a few different reasons for this. Firstly it could be that ‘women tend to be older and have more comorbidities [additional conditions]’.

‘It may also not just be to do with age, but how we treat people as well,’ he added.

‘Women can present with different symptoms after having a heart attack than men.

‘For example, as you see [with Marie], she has SCAD, which is more common in women than in men.

‘It can be difficult to detect and even be misdiagnosed, and we don’t really know what causes it or what the best treatment for it is.’

Previous research by the BHF found women are 50% more likely than men to receive the wrong initial diagnosis.

Professor Gale said one of the issues is, when we picture a person having a heart attack, we typically think of an overweight older man who probably smokes a lot and eats badly – but this is not always the case.

‘It’s a misconception that it’s a male phenomenon,’ he stressed, ‘And we need to change that public perception.’

He said part of this involves advising women to be as aware of their risk factors for heart attacks as men, for example high blood pressure, high cholesterol and family history. This way if they are experiencing symptoms they may be more likely to link them to a heart attack.

Another part of it, Professor Gale said, is to ensure women are being given the correct drugs and treatment for their conditions – something which he is in the process of applying for more funding from the BHF to research, and help reduce that gender gap.

Marie said life now is ‘fairly normal’ and she is back at work, following medical advice and listening to her body.

‘I think it would be great if there was more public awareness on the various ways heart attacks present in different people,’ she concluded, ‘And how it’s not always the way the media shows it to us as the man or woman clutching their chest.

‘For example, more awareness that someone in their 30s who seems outwardly very healthy can have a heart attack – someone like me.

‘If I knew this then maybe when all the symptoms came on I would have been more alert to what was happening. 

‘And if I hadn’t have gone to hospital that day when I was feeling so bad in the office, I don’t know what would have happened. I probably would have died.

‘Luckily I did go to work that day. If I was in my flat on my own, who knows.’

How Metro.co.uk is helping Beat Heartbreak Forever

The British Heart Foundation (BHF) has teamed up with Metro.co.uk to help raise awareness and funds – because hearts need help now more than ever.

Since the BHF was established in 1961, it has funded pioneering research leading to ground-breaking and lifesaving treatments like statins and heart transplants.

Coronavirus has cut the BHF’s ability to fund new research in half from £100 million to £50 million, but heart and circulatory diseases are still the world’s biggest killers. If progress slows, even more lives will be at risk. As the charity faces the biggest crisis in its history while a second national lockdown approaches, it urgently needs support.

Some important facts:

• There are around 7.4 million people living with heart and circulatory diseases in this country, including 900,000 with heart failure
• Heart and circulatory diseases cause more than a quarter of all deaths in the UK. That’s nearly 170,000 deaths each year – an average of 460 deaths each day
• Someone dies every eight minutes in the UK from coronary heart disease, the most common cause of heart attack and the single biggest killer worldwide
• Before the BHF existed, most babies born with a heart defect did not survive to their first birthday. Today around 8 out of 10 survive to adulthood

Dr Charmaine Griffiths, chief executive at the British Heart Foundation said: ‘The Covid-19 pandemic has been devastating for so many people, especially those with heart and circulatory diseases. But we face an unprecedented funding crisis that threatens to arrest real progress.

‘The shockwaves from such a drop in funding will be profound, stalling discoveries that could save and improve lives. We are urging the Government to establish a Life Sciences-Charity Partnership to give vital support to charity research over the next three to five years and protect the future of UK science.

‘Charities have driven breakthroughs which have turned the tide on some of our biggest killers including heart disease and cancer. But without Government commitment to funding, charities will be forced to make devastating cuts to their research which will be hugely damaging for patients and UK science.’

You find out more and donate to help Beat Heartbreak Forever here.

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