Going red for heart health in women

By: By Melonie McLaurin - mflomer@civitasmedia.com

ROCKINGHAM — When Suzanne McInnis had a heart attack in 2007, she was shocked to learn she had developed congestive heart failure. Like many women, she found it hard to believe her symptoms were heart-related.

With the nearly accidental discovery of her condition and the treatment that followed, McInnis will celebrate National Wear Red Day on Friday as a grateful survivor. An American Heart Association initiative, Wear Red Day aims to raise funds and awareness to educate people about heart disease and stroke in women.

“My symptoms were different from all the descriptions of heart attacks I’d heard,” she recalled. “I never had chest pain. I was just tired. Extremely tired, and still working.”

Her job as a nurse in an outpatient surgery was demanding, but she could not remember the last time she had ever had to miss a day.

“I never knew a heart issue was going on,” she said. “I was working 12 hours on call. I would come home in my nursing uniform after work, fall asleep in the den, and wake up the next morning still in my uniform. Then, I’d go upstairs, put on another uniform, and go back to work. There were several days of that. I was just so extremely tired. Then my left foot started swelling and I couldn’t get my shoes on. I was short of breath.”

That was when she knew she was not all right.

“I called work that morning to tell my supervisor I couldn’t come in because I could not get my shoes on,” McInnis said. “And of course, I heard my coworkers all laughing in the background about my inability to put on my shoes as an excuse for not being able to come to work.”

She laughs about that now.

McInnis said she wanted to be there, because there were several cataract surgeries scheduled for that day — but she knew something was wrong.

“It must have been a Wednesday,” she said. “Because my primary doctor’s office is closed every Wednesday. So instead, I went to see a cardiologist.”

Thinking she was battling mere fatigue, even as severe as hers was, she remembers being astonished to learn she was in congestive heart failure.

“The cardiologist said I had a viral infection that attacked my heart,” McInnis recalled.

Dr. Olujide G. Lawal of FirstHealth Cardiology said this is not as unusual as it might seem.

“The common cold viruses like adenovirus, that would cause a flu-like illness, can affect your heart without a doubt,” Lawal said. “The damage caused is picked up long after the virus has left. The person may present — a couple of weeks later or months later — with heart failure. They are mostly common cold viruses.”

That attack damaged her heart, leading to cardiomyopathy and a blockage. She had only a 10 percent ejection fraction by the time she was exhausted enough to seek medical attention. Around her heart, 20 pounds of fluid had accumulated, and her cardiologist made a call that may have saved her life.

“Dr. Parrish, who I saw at the time, said, ‘Suzanne, I’m going to put you on some magic medicine. It doesn’t work for everyone, but we don’t want to talk about what will happen if it doesn’t work.’ I said, ‘Are you talking about a heart transplant?’ And he said ‘yes.’”

McInnis remembers asking how long she might live if the medicine didn’t work.

“He said I probably had a three-year heart,” she said.

The “magic medicine” Parrish prescribed, carvedilol, is a beta blocker used to treat high blood pressure and heart failure, and can reduce the risk of death following a heart attack.

“Dr. Parrish moved somewhere else and is no longer at FirstHealth,” McInnis said. “I have Dr. Lawal now, and I take my magic medicine every single day. I also believe in Wear Red Day, and I’m a survivor.”

She had a single stint put in to treat the blockage, and after some time it became clear the carvedilol was working its magic.

“I went through cardiac rehab, but I had to wait a while before I could begin it,” McInnis said. “But the medicine is working. I do not swell up. I do not have shortness of breath. I think you have to have a real faith in your cardiologist — and I did. Everything he said, I did. I now carry aspirin with me every day just in case I have heart pain, but I have not had to use it.”

Lawal said heart disease and failure in women can be more difficult to identify and treat because of the differences in the way men and women present with symptoms.

“The signs of it are not very clear, but Suzanne is a prototype of exactly what the issue is here,” he explained. “Women present differently. It could be hormonal differences which account for that. And women generally don’t like to bother someone as much with their problems until it’s really significant.

“We’re not so sure how women present so differently,” Lawal continued. “Some people have postulated that it could be an entirely different disease, because of the fact that we do not know for sure. The anatomy of the disease has some similarity, but the way it manifests — it is almost like a totally different disease.”

McInnis said her health has improved and she is now able to do many of the things she found difficult or impossible after her heart attack.

“I miss nursing terribly, but I couldn’t keep up with that job now,” she said. “It’s a hard job. I do still have trouble getting up and down the stairs at my house. I’m off the cane and not falling around anymore, but I am no longer working. If it hadn’t been for my daughter helping me do things during those first weeks and months, I don’t know what I would have done.”

McInnis said she’ll be donning a red T-shirt on Friday.

Lawal said that while it is true some people do not respond to carvedilol, it does help most patients with heart failure.

“Most people will have significant improvement in their heart failure symptoms over time, but the response may vary,” he explained. “Her ejection fraction improved. Clinical improvement — which means an improvement in symptoms — is nearly universal. So these are two measures of response to the medication.”

Lawal said self-risk stratification is important for women in determining whether they may be experiencing cardiac symptoms. It is simply the process of examining, and counting the number of, known risk factors an individual has.

“Whether you are premenopausal or postmenopausal makes a difference,” he said. “If you are postmenopausal, it increases your chances of having a heart attack. There are other conditions that contribute, such as diabetes, hypertension, and a family history. And other risk factors — smoking, having high cholesterol and unusually extreme fatigue — should be included.

“By and large, women have symptoms that are not classic textbook, such as chest pain,” Lawal reiterated. “You have to risk stratify yourself first, and any symptom out of the ordinary that is not responding the way you think it should, you should find out what it is.”

He said any woman who is postmenopausal already has one risk factor — and that the presence of two or more factors warrants screening tests for heart disease.

“What we’ve preached to primary care doctors is to be more aggressive in evaluating women with these risk factors,” Lawal continued. “It is important to pay close attention.”

Lawal said he, too, will be wearing red on Friday.

Reach reporter Melonie McLaurin at 910-817-2673 and follow her on Twitter @meloniemclaurin.



By Melonie McLaurin