Carrie Fisher's Heart Attack Should Be No Surprise
Heart disease is the No. 1 killer of men and women in the U.S.
Carrie Fisher. George Michael. Alan Thicke. The sudden deaths of the three celebrities from heart issues towards the end of 2016 should remind us that coronary artery disease is the No. 1 killer of both men and women in the U.S. And yet we often don’t pay much attention to the threat it poses.
That’s especially true for women, said Dr. Sharonne N. Hayes, a cardiologist and founder of the Women’s Health Clinic at the Mayo Clinic in Rochester, Minn.
“Many women, because of the focus on reproductive health, on breast health, on breast cancer, they think that's their biggest risk, and that is their main focus on health prevention,” Hayes said.
But in fact, heart attacks kill six times as many women each year as breast cancer, according to the Women’s Heart Foundation. The average age for heart attacks in women is the mid-sixties, but heart attacks can occur in women in their twenties and up.
Heart Issues: All Too Common
Fisher was 60 when she reportedly suffered a massive heart attack (or, possibly, heart failure) on a flight from London to Los Angeles last Dec. 23, 2016. The actress and writer, beloved for her role as Princess Leia in the Star Wars series, died the following Tuesday. (Her mother, Debbie Reynolds, died the following day at age 84, reportedly of a stroke.)
British pop singer Michael died on Christmas Day at 53, also of heart failure, according to his manager. Thicke, a Canadian actor best known for his role in ABC’s Growing Pains, died Dec. 13 of a ruptured aorta, sources said.
Also on Tuesday, it was reported that comedian Garry Shandling died of a blood clot in the heart. Shandling, 66, died March 24 after calling for emergency help at his Los Angeles home. The cause of death announcement was delayed because of toxicology tests and a review of his medical records, reports said.
Don’t Blame Cocaine
In stories about Fisher’s death, media outlets have widely noted that she had a history of illicit drug use, including cocaine. This has fueled speculation that the drugs played a key role in her heart attack.
But that’s highly unlikely, said Dr. C. Noel Bairey Merz, medical director of the Women’s Heart Center at Cedars-Sinai in Los Angeles. “Drugs and alcohol are not risk factors for heart attacks with a few exceptions: young people who are doing a lot of cocaine, or the freebasing; while doing that, they can have a coronary spasm and a heart attack and die,” she said. “That was not Carrie.” (Bairey Merz has no personal knowledge of Fisher's health, she acknowledged.)
The fact that Fisher was a woman makes us less likely to think her death was due to simply heart disease — and that’s unfortunate, Bairey Merz said.
“She had heart disease probably for the traditional reasons that most women die of heart disease,” Bairey Merz said. “It's the leading killer of Americans — why are we shocked?”
Heart Disease: Not a Top Concern
Forty-seven percent of women surveyed as part of a recent study did not know that heart disease is their gender's leading cause of death, Bairey Merz said. And among those who do know, “very few women think that it's going to get them,” she said. “Very few women personalize it.”
In fact, Americans’ most feared diseases are cancer and Alzheimer’s, with heart disease lagging far behind, a 2011 survey for the MetLife Foundation revealed.
Even if it doesn’t kill you, heart disease can cause other problems, Bairey Merz said. It’s the leading contributor to disability, such as Alzheimer’s and other dementias, as well as recurrent hospitalizations and large out-of-pocket expenses.
Symptoms of a Heart Attack
These are common symptoms of heart attacks:
- Chest pain, pressure or squeezing About two-thirds of men and one-third of women will experience what Bairey Merz calls “the classic Hollywood heart attack,” with pain or discomfort in the chest.
- Jaw or arm ache/pain This is more common for women, Bairey Merz said.
- Upset stomach or heartburn Women are more likely to ascribe their symptoms to an upset stomach or gastroesophageal reflux disease (GERD), Bairey Merz said. Doctors more often think that stomach symptoms in women indicate a gall bladder problem, she said. Both women and men may experience nausea and vomiting with a heart attack.
- Shortness of breath This symptom is more common in women.
- Lightheadedness You may be dizzy or feel as if you are going to pass out.
- Sweating You may break out in a cold sweat.
Most people have some symptoms of heart disease in the months leading up to a heart attack, though they may attribute the signs to something else, Hayes said.
One of those is exercise intolerance — which older adults may brush off as simply a byproduct of aging. If you are accustomed to going on walks and find yourself avoiding them, for instance, talk to your doctor, Hayes said.
“The biggest public health message for men and women is: know all the heart attack symptoms and if you have them, then you call 911 — you don't drive yourself, you don't ask your spouse to drive you, you don't call a neighbor,” Hayes said.
Heart Disease Risks
The top risks for heart disease are the following, according to American Heart Association:
- High cholesterol
- High blood pressure
- Sedentary lifestyle
- Being obese or overweight
- Diabetes, especially if not well-controlled
- Increasing age
- Family history of heart disease
Of course, we have no control over some of those factors, like increasing age. But many heart attacks can be prevented by addressing lifestyle factors, experts say.
“We really could do so much better if we could get women to recognize [heart disease risks] and take some action,” Bairey Merz said.
Medical providers need to do more, too, in the area of prevention, Bairey Merz said. For example, Ob/Gyn doctors should be testing patients’ blood pressure and urging them to stop smoking, because many women don’t see a general practitioner, she said.