Heart attacks: His versus hers

The camera zooms in on a man. He's middle aged, possibly a little overweight, and clutching his chest. He grunts; his face is sweaty and his features contorted in pain. Around him, alarmed bystanders jump into action, whipping out cell phones and helping him to a chair before he collapses.

If all heart attacks looked like the Hollywood stereotype, we would know right away what was happening and immediately call 911. In real life, the symptoms are often less dramatic, and a failure to recognize them can lead to dangerous delays getting help -- especially for women.

According to the Canadian Heart and Stroke Foundation, about 70,000 Canadians suffer a heart attack each year, and roughly 17,000 people will die as a result. Heart attacks are responsible for one quarter of all cardiovascular disease deaths (the top cause of death in Canada).

While men have a higher risk of having a heart attack than women, and have them at a younger age, women often experience subtle or unusual symptoms. According to a new survey, not recognizing the signs -- or seeking help soon enough -- can have disastrous consequences.

Delays can be deadly for women

Prompt treatment for a heart attack is crucial for a good outcome -- and the earlier you get treatment, the better. Heart attacks occur when a blood clot blocks the flow of blood to the heart and deprives this crucial muscle of oxygen. The longer it goes untreated, the more permanent damage can be caused.

Not getting help quickly enough can turn deadly. According to the British Heart Foundation (BHF), people who are treated within two hours of symptoms first appearing are twice as likely to survive as people who are not treated within four hours. In Britain, one third of people die before reaching the hospital -- often because they wait too long. In Canada, most heart attack deaths occur outside of a hospital.

But here's the scary part: a new survey from the BHF found that what women don't know about heart attacks can kill them. One third of the women surveyed said they wouldn't recognize they're having a heart attack unless they were experiencing crushing or severe chest pain (a symptom more characteristic of heart attacks in men). However, experts have long known that women are more likely than men to experience less dramatic symptoms, and may not have chest pain at all. As a result, they may be overlooking or dismissing dangerous signs.

Worse yet, women may be afraid to seek help because they don't want to cause a fuss. The survey found that 35 per cent of women wouldn't call emergency services because they're afraid of being embarrassed if it turns out to be something minor.

"There is no need to feel embarrassed about getting it wrong," says Dr. Mike Knapton, BHF Associate Medical Director, in a recent press release. "Saving your life is more important than saving face."

Furthermore, even when they do recognize the signs of trouble, women tend to wait longer than men to call emergency services. The lag time? An average of 24 minutes (according to previous research), which is far too long to wait in a life-or-death situation. Some previous U.S. studies found that women may wait up to an hour longer than men -- putting them at or beyond the four hour mark from when they first started noticing symptoms.

"Every second counts when you are having a heart attack, and calling 999 [911 in Canada] at the very first sign means you are much more likely to survive," Dr. Knapton warns.