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Could a "Heart Detective"
Doctors in Franiinyham, Mass., seek early detection via series of blood-pressure tests (left), blood samplings, and X rays.
"Of the hundreds of articles I've written," says
this author, "this was the toughest; yet it had to be done as
a warning to other women, other mothers of kids like my own"
ON the balmy evening of March 27, my wife
and I were vacationing at a beachfront
motel in Sarasota, Fla.
As Rita sat back reading a novel, she suddenly felt
nauseous, rose, and walked unsteadily toward the bath
room. At the door, she uttered an almost inaudible moan,
then collapsed, unconscious. I sprang to her side and car
ried her to a bed. For a moment she revived, put a hand
to her chest, and winced as if in pain.
I phoned for a doctor. Luckily, Dr. Rudolph Garber
lived just a few blocks away. He arrived within five min
utes. After feeling Rita's pulse and applying his stetho
scope, he summoned an ambulance.
"Is it a coronary?" I asked Dr. Garber.
He nodded. "Almost no pulse or heartbeat."
Rita evidently overheard his remark. "Isn't this silly
of me?" she whispered.
On the way to the hospital, trailing the ambulance in
Dr. Garber's car, he told me: "We're lucky if your wife
gets there alive. She has an acute myocardial infarction."
(That's a stoppage of one of the large arteries supplying
blood to the heart muscle.)
For five hours, Dr. Garber and two nurses used every
known technique to keep my wife alive. The end came
shortly after midnight.
I found it impossible to believe. There hadn't been the
slightest warning that something was wrong. Rita, at 53,
seemingly had been in excellent health. That pleasantly
sunny day on the beach, she had been cheerful and vi
brant as always, under no strain.
Next morning I asked Dr. Garber: "What do you think
caused my wife's heart attack?"
He shook his head. "We don't know."
Since then I've wondered: could Rita's sudden death
have been averted somehow? If she had been prone to
heart disease, could doctors have detected the "heart
attack type" and done something about it?
Like most women, Rita had thought of heart trouble as
a "man's disease." Such magazine articles as "How to
Protect Your Husband's Heart" had inclined her to worry
about me, not herself. Presumably other women also are
exposing themselves to heart attacks.
As a medical writer, spurred by the devastating loss
of my wife, I decided to find out what science has learned
M Family Weekly, October 23. 1962
thus far about women and heart disease. After talking to
leading heart specialists, I went to the National Heart
Institute in Bethesda, Md., the federal agency that spon
sors more than 2,000 heart-research projects throughout
the country. These are the harsh facts I uncovered:
Up to the age of 50 (or menopause), women suffer from
various types of cardiovascular disease but they seem
to have a natural protection against dying from them.
During her childbearing years, the female sex hormones
(estrogens) apparently keep a woman's coronary arteries
from hardening or thickening. Menopause is believed to
remove this protection.
rpnus, while up to the age of 50, men have a five-times
JL higher death rate from heart disease than women, the
ratio after that is almost even. In recent years, both acute
myocardial infarction and angina pectoris have been as
common in women as in men.
Sudden death, as in my wife's case, occurs in one out of
six heart fatalities. For these, and other types of coro
nary heart disease which can be helped only partially by
treatment, the answer clearly lies in prevention.
"It is now possible," says Dr. Jeremiah Stamler, direc
tor of Chicago's Heart Disease Control Program, "to find
out whether a heart attack is likely to strike and pre
vent it. Susceptibility and proneness can be measured."
Through the National Heart Institute and the Ameri
can Heart Association, the multi faceted nature of heart
trouble is being attacked by medical investigators or, as
I call them, "heart detectives," from many directions. As
part of their Heart Disease Control Program, long-range
studies are going on with thousands of people in at least
a dozen communities, including Minneapolis, Los An
geles, Claxton, Ga., Albany, N. Y., Tecumseh, Mich., and
Framingham, Mass.
From such research projects, investigators can now
point to the main factors that heighten the risk of heart
disease. In effect, these may be the characteristic features
in the profile of the coronary-prone:
1. High blood pressure (hypertension) affects twice as
many women as men in the U.S. Over a period of years, if
undiagnosed and untreated, it speeds up the deposit of
foreign material in the coronary artery and, in time, can
permanently damage the heart by enlarging it to the point
where it can't function properly. With hypertension, the
Have Saved
mm
Periodic X rays reveal any heart enlargement.
chances of heart disease are increased sixfold among
women aged 40-59; among men, the threat is less than
half as great.
2. Danger is increased two or three times when, in
addition to high blood pressure, an X ray or electro
cardiograph shows enlargement of the heart's main
pumping chamber, the left ventricle. This can be due to
hypertension or to various forms of structural heart
disease, medical experts say.
3. Diet, or more precisely the kind of fats you consume,
may be an important influence. A number of medical
authorities suspect that a high level of cholesterol, a
fatty substance in the blood, is "associated" with heart
attacks. At Framingham, Los Angeles, and elsewhere, it
appeared that people with high cholesterol were about
four times more vulnerable to heart disease than those
with low blood fat. (Many experts, however, maintain
there is no conclusive proof that changing dietary habits
of fat consumption will actually reduce the peril of having
a heart attack.)
4. Heredity increases susceptibility. If two or more
members of your family have had heart disease, the odds
are that you will develop it, too.
5. The study in Framingham shows a definite link
between overweight and heart disease. Obesity boosts the
hazard of myocardial infarction by about 50 percent.
6. The presence of diabetes is four times more common ,
among women with acute myocardial infarction than
among those in the general population.
7. Heavy smokers, according to combined reports from
Framingham and Albany, "experience a threefold in
crease in incidence of myocardial infarction" as com
pared with nonsmokers. (The American Heart Associa
tion, however, believes that further rewarch is needed
over a long period for definite proof that smoking
"causes" coronaries.)
Scientific evidence also is lacking on other suspected
factors. Does stress or tension bring on heart trouble?
Experts aren't sure. Significantly, however, a recent sur
vey in San Francisco of 69 hard-driving, aggressive
career women in competitive jobs disclosed that they had
five to eight times more heart trouble than housewives of
the same age.
Lack of exercise is being increasingly suggested by
medical researchers as an important cause of coronary
disease. One recent study showed that people in sedentary
occupations had three times as many heart attacks as
those who worked at hard labor.
I found it revealing, though sometimes mystifying, to
My Wife?
The author poses with wife Rita in happier days.
By THEODORE IRWIN
compare my wife's case with this picture of the coronary
prone. Rita's father had died of coronary thrombosis,
her mother died of a stroke, and a young sister was the
victim of rheumatic fever.
Rita smoked heavily and frowned on all forms of exer
cise. Yet she was not overweight, and if she had high
blood pressure, diabetes, or enlargement of the left ven
tricle, she was not aware of it. Her cholesterol level had
never been measured, although since she was just past
menopause, she was particularly vulnerable.
Could a "heart detective" or any competent doctor
have warded off her fatal attack? Whatever the
answer, I'm convinced that most women would be wise
to take the simple preventive measures available to them.
Obviously, my wife was stuck with her heredity, but
she could have accepted it as a hint to control or combat
other factors, thus lessening her chances of a premature
attack. A medical check-up, which she was always reluc
tant to undergo, might have detected hypertension. Then
she could have been treated with any one of a variety of
effective drugs to lower her blood pressure. With these
and other medical tools, people with severe hypertension
are living longer, and those with milder forms have fewer
heart attacks.
If her doctor had found that Rita's blood cholesterol
count was too high, she could have reduced it by changing
her diet. Members of anticoronary clubs in Chicago and
New York have been able to drop their cholesterol levels
by 10 to 20 percent.
Apparently, as was the case with Rita, many women are
not even alerted to the symptoms of heart disease. "Wom
en are often neglectful of themselves," Dr. Donald S.
Fredrickson, clinical director of the National Heart Insti
tute, told me. "They should pay attention, for instance, to
a chest pain in cold weather when they take clothes out
to the line it could be a sign of angina pectoris. Visual
difficulties, dizziness, or a certain characteristic headache
may reflect severe hypertension. Unusual shortness of
breath, attacks of fainting, or prolonged palpitations (an
irregular heartbeat) are other warnings."
Sudden death "struck from the blue" brings a chill
fear of the unknown to the family of a victim who had
been in the prime of life. But we should realize that it is
within our power to do something that can prevent or
postpone a heart attack.
I can't forget my wife's last words: "Isn't this silly
of me?" It is my hope, in writing this painful article, that
Rita's case can be an object lesson to all women.
family Weekly, October 21, 1962
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