Women's Experience Living With Coronary Artery Disease (CAD)

Coronary artery disease (CAD) is the leading cause of death among women in the United States, and in some years even more women die from CAD than men. Yet many women don't realize they're at risk.

Toshawa Andrews, 33, was in the middle of a figure skating test when she suddenly felt a sharp pain in her chest, "It made me say 'Oooh!' Then suddenly I was exhausted, I had to go to the bathroom, and I had really bad heartburn, but I continued to take the test."

Lori Kupetz, 41, was hiking with a friend when she felt a blinding chest pain that quickly went away. Soon she was consumed by fatigue, "After six or seven months I couldn't carry groceries, I couldn't have sex, I couldn't dance with my daughters without feeling chest pain," says Kupetz.

Karen Sanson, a thin, fit 60-year-old started to wake up in the middle of the night unable to breathe. "I also felt very fatigued," she says, "even though I usually have mounds of energy and go till I drop."

None of these women seemed at risk for heart disease, yet two ended up having (and surviving!) heart attacks and all three were diagnosed with coronary artery disease.

Recognize the symptoms
In the months leading up to a heart attack, as one study of women with CAD found, less than a third of the women felt chest pain, but many experienced fatigue, dizziness, indigestion, nausea, and shortness of breath.

Kupetz, of Sherman Oaks, Calif., had a family history of heart disease and high cholesterol and had been on cholesterol-lowering medication since age 20. But a stress test and EKG she had after an episode of chest pains and fatigue appeared normal.

She found her way to C. Noel Bairey Merz, MD, medical director of the Women's Heart Center at Cedars-Sinai Medical Center in Los Angeles. "Lori had CAD that failed to be diagnosed for almost a year, but using gender-specific testing we were able to apply lifesaving treatment," says Dr. Bairey Merz. Kupetz had 98% blockage in one of her main arteries and two other blockages—she needed emergency triple-bypass surgery. "It was amazing that I was alive," says Kupetz. "If I hadn't been assertive and aggressive, I'd be dead."

About half of women with CAD will have atypical symptoms that are more likely to be misdiagnosed, says Dr. Bairey Merz, "They might be treated for acid reflux, they might be told they have gallbladder disease or even tennis elbow. But many women do have classic symptoms like chest pain and we don't want them to ignore it."