Living Well

Safeguard Your Health, Check Things Out – Expert Advice from Dr. Michele Nitti

Last updated: Feb 13, 2018

The following article is by Dr. Michele Nitti, a family medicine physician in Glen Ridge. Before joining SMG, Dr. Nitti co-founded the Montclair Family Practice. She appears on the 2017 list of New Jersey’s Top Doctors. The article is part of an ongoing health series contributed by SMG physicians for Montclair Local

The following journal entries are from a fictional female patient about to experience a heart attack.

Sept. 14 — Today was a busy day — work is crazy and the kids are not settled yet in school. Thankfully, I worked out, but I had an odd twinge in my chest. I was worried at first, but it went away 10 minutes later.

Sept. 30 — I feel more tired than usual lately. I must not be getting enough sleep. I still get that fleeting pain in my chest sometimes but I don’t feel tingling down my arms. It can’t be anything serious — I’m only 48! I eat healthy, exercise, don’t smoke or drink too much, and no one in my family has heart problems. Maybe I should see my doctor… but seriously who has the time?

Oct. 26 — The kids are doing better and I haven’t had that chest pain recently — it must have been stress or the beginnings of menopause. My friends say they feel achy and tired sometimes, too.

Dec. 15 — My chest pains came back today and wouldn’t stop. My doctor sent me to the ER. The cardiologist said I was lucky — they prevented a major heart attack! I should have seen someone when the pains first started.

This story describes many of the female patients I have seen in practice over the past 30 years. Heart disease is the leading cause of death nationwide in both men and women. Unfortunately, there is no ideal test to predict who might be at risk for a heart attack.

That is why February’s Heart Health Month is the perfect time to increase awareness about the signs of coronary artery disease (clogged arteries). Most of us know how to help prevent heart disease — eat healthy, quit smoking, keep our weight down and exercise regularly. But how do we know if we have heart disease?

We hear a lot that women have different heart attack symptoms than men. Is that really true? Do doctors have different impressions of those symptoms?

I would argue that the symptoms of a heart attack are similar in men and women.  Typically, more men have heart attacks in their  50s while women tend to present later, in their 60s. But I have also seen plenty of 50-something women who have had a heart attack or angina — chest pain related to coronary artery disease.

Consider the following scenarios. A 50-year-old man, a former smoker with a high-powered job, experiences a pain described as “an elephant sitting on his chest” while running at the gym. His family and physician rush to get him evaluated.

Now consider a 48-year-old woman who is the picture of good health and has just entered menopause. She has been experiencing symptoms for months, including chest and jaw pain, fatigue, nausea, dizziness and shortness of breath. Everyone assumes she couldn’t have a heart problem. But they are wrong — she just doesn’t fit the stereotype.

It is difficult to know when to take symptoms seriously. My advice for women and men alike is to listen carefully to your body and see your doctor if something does not feel right.    

Dec. 26 — So thankful to be back home with my family. Why did I wait so long? I’ll never ignore my body again.

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