03/02/2008

Associated Press

At 27, Rachel Alexander was running three miles a day, and her karaoke friends called her "The Energizer Bunny."

At 37, Tracy Finck of Umatilla was coaching girls basketball and jumping up from the bench to protest a bad call.

Neither was a likely candidate for a heart attack.

"This is a huge mistake," said Dr. Diana Rinkevich, a cardiologist and director of Oregon Health & Science University's Heart Disease in Women Programs. "One in three women will die from heart disease or stroke."

That's more than breast cancer, which kills one in 30 women.

Both Alexander and Finck survived their heart attacks, although Finck says she has no memory of it.

EMTs used a defibrillator on hand at the Riverside High School gym in Boardman to jump-start her heart, and repeated that in the ambulance on the way to the hospital.

"They said I died twice," Finck said.

Women may experience different symptoms than men do and often doubt they are having a heart attack, Rinkevich said. Symptoms can appear a month before an attack. Besides the classic symptom of chest pain, women also report anxiety, difficulty going to sleep, tiredness, shortness of breath and pain in the back and neck and other regions of the upper body.

She urged women to pay attention to risk factors such as heart disease in the family.

Heart disease in young women, such as Alexander and Finck, often is genetic, though it's still the biggest killer of young women.

Alexander's father died of a heart attack at 45 as he played basketball. She had a condition called aortic dissection, where bleeding in the aorta is life-threatening.

Finck has a genetic condition called Long QT Syndrome, a disorder of the heart's electrical system where chaotic heartbeats sometimes lead to fainting and, as with Finck, cardiac arrest.

Generally, women start to suffer heart disease about 10 years later than men. By about age 65, men and women have about the same incidence of heart disease. But chances of surviving a heart attack are less.

"The prognosis for women is worse than for men," Rinkevich said. "Thirty-eight percent of women die in the first year, compared with 25 percent of men."

In addition, 35 percent of women will have a second heart attack in the next six years, compared with 18 percent of men, because research has been done almost exclusively with men and mortality is higher for women during bypass surgery, Rinkevich said.

She urged women to be as careful about cholesterol checks as they are about mammograms.

Early diagnosis is another problem area. Doctors sometime veer away from heart problems in favor of other diagnoses, before ordering heart tests, she said.

"We have a tendency to wait," she said. "By the time we send them, it may be too late."

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Information from: East Oregonian, http://www.eastoregonian.info