One in four women in Ireland will die of cardiovascular disease, yet many of us do not know the symptoms to look out for. Here we speak with Shirley Ingram, an Irish woman who suffered a heart attack at the age of 50, about the importance of knowing the facts and seeking help when you need it
"If it could happen to me, it could happen to anybody..."
Irish woman Shirley Ingram suffered a heart attack in April 2018, aged just 50 years old. She didn't have any of the typical risk factors; no high blood pressure, no high cholesterol, no diabetes and she wasn't a smoker. If anything, she was incredibly fit, with a passion for the gym and park running ("I can run 5 km, no problem, if my knees hold up").
Never in a million years did Shirley think this would happen to her – but, one morning while running on the treadmill – it did. It is with thanks to her 30-year-long career as a cardiac nurse and her expert knowledge of heart attack symptoms that Shirley knew exactly what she needed to do.
Now, as a new ambassador for the Irish Heart Foundation's 'Go Red for Women' campaign, Shirley wants to encourage other women to be aware of the symptoms too. What's more, she's asking women to always put their health first and to seek immediate medical attention if they feel like something's wrong.
Photo: Shirley Ingram, ambassador for the Irish Heart Foundation
The day it happened
"I was in the gym, running," Shirley tells IMAGE.ie. "I had a bit of an ankle injury and had been off for a while, so I was just testing it out and wasn't running fast... and then I got my symptoms."
It may surprise readers to hear that she didn't experience chest pain, something which Shirley explains is quite normal in women's heart attacks. "People have the impression that you must have crushing chest pain and collapse to have a heart attack. Some people can have that, and quite a lot of people do have that – especially men. I know that from my job as an advanced nurse practitioner; I see people like me in work every day, of all ages, all different backgrounds, all different risk profiles.
"But people can also present with chest pressure, chest ache, a burning sensation, indigestion, jaw pain, throat pain and face pain, so it’s not just as simple as having a pain in your chest. It’s all the other things that go with it," Shirley says.
Symptoms of a heart attack are not the same for everyone, but the most common ones include
– Chest pain
– Upper body pain in the jaw, back, neck or arms
– Shortness of breath
– Loss of consciousness
However, according to the Irish Heart Foundation, 10-15% of people who have a heart attack may not feel anything at all. This is more common in older people, especially women and those with diabetes. "Sometimes these people just feel weak, tired or short of breath," they say, while "some elderly patients may simply become confused."
'Like nothing I've ever felt before'
While Shirley had no chest pain, she did have pain in both of her shoulders and a burning discomfort in her throat. Her arms also felt tight and her hands felt numb. She couldn't be 100% sure it was a heart attack without an ECG, but Shirley says, "I had a feeling in my bones that something was terribly wrong. I've had illnesses in the past but this was completely different. It was like nothing I've ever felt before.
"Throat pain, jaw pain, face pain – if anyone says that to me in a work situation my antennae immediately go up. So once it went to my throat, I just knew. I sat there and I thought, 'Oh my god, this is how women feel when they're having a heart attack’.”
Sitting on a mat in the gym, Shirley went through her symptoms in the same way she would with a hospital patient. "In my job, I have to come up with a differential diagnosis for people who come in with symptoms, and once I rule out a heart attack, I'm thinking, 'Okay, is this the stomach? Is it the lungs? Is it muscular? Is it psychological?' I'm always thinking of five or six potential causes for symptoms – so naturally, I was doing that to myself.
"I was trying to diagnose myself, and I couldn't come up with any other diagnosis but a woman's heart attack," she says.
Every minute matters
As heart attacks can be life-threatening, it's vital to seek medical attention right away (even if you're not 100% sure what the problem is). Every minute can matter, so calling an ambulance on either 999 or 112 could save your life.
Shirley went straight to the emergency department in which she works – but rather than starting a shift, she sought an immediate ECG (a test which measures the rhythm and electrical activity of the heart). "My colleagues couldn't believe it," she says, "but they were all amazing, and I was treated just like any other patient.
"Once I had the ECG, I knew – because I could read it myself – I knew that my heart was being damaged. Plus I was becoming quite unwell at that stage. My blood pressure was very high and I was very cold and clammy. I had more ECGs, I had blood tests and then I went immediately to the cath lab."
When a doctor confirms a person has had a heart attack, the blocked artery needs to be unblocked as quickly as possible. The Irish Heart Foundation says this is done with an emergency angioplasty and possible stenting of the artery to open it and restore the blood supply to your heart.
Alternatively, you may be given a 'clot-busting' drug called thrombolysis that is injected into a vein and dissolves the clot, restoring the blood supply.
The emotional strain of heart attack
"Having a heart attack can be a frightening experience and it is natural to be worried or concerned," says the IHF. "How you recover will depend on the size of the heart attack, your age and if you have any other illnesses. Most people recover in about six to 10 weeks and are able to return to their normal activities.
"Taking part in a cardiac rehabilitation course can help you come to terms with what has happened and get you back to normal as quickly as possible."
Shirley highly recommends this too. "I would encourage people – women, especially – to avail of the cardiac rehab program for support, and to join the Irish Heart Foundation support groups; because even for me as a nurse, you would think I knew it all, but I needed the support of other people who've been through the same thing."
Reduce your risk of heart disease
Luckily, there are many ways women can reduce their risk of heart disease and heart attack. Simple lifestyle changes, plus learning about your family's medical history, can help you to lead a long and healthy life. The best ways to maintain a healthy heart include:
– Being active. Get your pulse racing for at least 30 minutes, five days every week (a brisk walk will do the trick).
– Eat well. The Irish Heart Foundation recommends incorporating more grains (such as rice or quinoa) and fish into your diet, as well as lots of fresh fruit and vegetables. Foods filled with saturated fats are not good for your heart at all.
– Stop smoking. After one year of quitting, the risk of sudden death from heart attack is cut almost in half.
– Reduce alcohol consumption. Health experts advise women to keep under 11 standard drinks a week.
– De-stress. Do whatever it takes to unwind. Whether it's a walk, listening to music or chatting with friends – take time for yourself to switch off.
– Have regular check-ups. Regularly check your blood pressure and cholesterol levels with your GP, and keep your weight within a healthy BMI range.
For more information on heart disease or for advice on how to improve your heart health, visit irishheart.ie.
Illustration by Sophie Teyssier
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