Mark Sanchez scored points in last week’s Super Bowl broadcast—not for playing, but for a public service announcement about women and heart attacks. It’s an important message, but a 20-second spot didn’t leave much time for details (like actual symptoms, for instance). We asked cardiologist Holly S. Andersen, M.D. of the WVFC medical advisory board to spell out exactly what women need to know. — Ed.

Heart disease is the number-one cause of death for both men and women in the US. It kills more every year than all cancers combined—and the next six causes of death combined. Since 1984, more women than men have died from heart disease in this country every year. And once a woman is diagnosed with heart disease, she’ll do worse and will more likely die from it than a man will.

In the US today, a woman having a heart attack will typically wait longer before presenting to an emergency room.  She’ll be less likely to have the classic symptom of crushing chest pain, and will be less likely to receive a diagnostic electrocardiogram. Not surprisingly, she’ll be less likely to be diagnosed correctly. Even if she is, she’ll be less likely to receive all the life-saving therapies we now have to treat heart attacks.

It gets worse.

Even if the decision is made to give her these therapies, they will be given, on average, at a 13-minute time delay compared to a man.

Those of us who treat heart attacks  have a saying: “Time is muscle.”  And even if you control for all of these variables (getting the electrocardiogram, the correct diagnosis, and lifesaving therapies without the 13-minute time lag), a woman is still more likely to die from her heart attack than a man. The greatest discrepancy in survival rates—in other words, the highest death rate compared to men in the same age group—is among women ages 35-50. And we don’t know why.

The American Heart Association recently reported that 53% of women who believe they are experiencing symptoms of a heart attack will call 911. That means that 47% of them will not call 911. A report from Boston last year found that among almost 6,000 emergency calls for suspected heart-attack symptoms—with about half of them made by women—women were 52% more likely to experience delays by EMS responders.

What are the symptoms of a heart attack? The most common is chest pain, but it’s rarely the severe, clutch-the-chest spasm depicted by Hollywood. It’s true, chest pain is the most common symptom for women experiencing a heart attack (about 45 percent), but women are more likely than men to experience atypical symptoms and “silent” heart attacks. Symptoms can include back pain, arm pain, or throat or jaw pain. Women can also experience symptoms similar to indigestion, or shortness of breath, sweatiness, or profound fatigue.

It comes down to this: if you are not feeling right, get checked out. We would much rather treat indigestion in the emergency room than miss a heart attack that is so easily treatable today. And please, if you think you are experiencing heart attack symptoms, call 911—not your doctor. Remember, time is muscle. And if you think it’s more important to neglect yourself so you can pick up your daughter from school, consider this: you might not be around to watch her graduate. Also, our daughters don’t do what we tell them to do when they grow up, they do what we do. So take it from a cardiologist: Start taking charge of your life, take care of your health, and seek help if you are not feeling right.

Holly S. Andersen, M.D. is the Director of Education and Outreach at The Ronald O. Perelman Heart Institute, The New York Presbyterian Hospital and Weill Cornell Medical College. She is a member of the Women’s Voices for Change Medical Advisory Board.

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