Barnes-Jewish Hospital | Washington University Physicians
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Woman's Symptoms Not Typcial of Heart Attack

Originally published Oct 2003

by Kay Quinn, KSDK Newschannel 5

October 3, 2003— Women usually worry about dying of cancer. But they have almost double the risk of dying from heart disease. In fact, women who survive heart attacks have almost a 50-50 chance of developing heart failure. That''s compared to men who only have a 25 percent chance of going into congestive heart failure in the five to ten years after a heart attack.

Doctors believe the big difference is that heart attacks in women are frequently diagnosed late, allowing the heart to suffer even more damage.

"My doctors kept convincing me it couldn''t be my heart," says Ruth Mullins-Julson, a heart failure patient.

That''s because Ruth Mullins-Julson was just 27 when she started to get sick, and she didn''t have the classic symptoms of a heart attack.

"A lot of women have very unusual symptoms, they''ll have nausea, they''ll have fatigue, things that are much more vague and very difficult for a physician to pick up," says Dr. Joseph Rogers, a Barnes-Jewish cardiologist.

This paralegal''s pain was in her upper abdomen and left elbow.

"Over the course of a year and a half they did a lot of tests took my gallbladder out and finally decided I was depressed

But the pain continued. Then suddenly, she gained 20 pounds in water weight.

"I went to the same doctor who told me I was depressed and he told me it was heat related water retention," says Mullins-Julson.

"I went to the emergency room and sat in the freezing cold E.R. for five hours and they told me it was heat related water retention and sent me home.

Finally, in the middle of that week my supervisor said you''re having some kind of organ failure and if your doctor is not going to do something about it then mine will."

An echocardiogram revealed serious heart damage from years of undiagnosed heart attacks.

"One of them came in and said Miss Mullins, I have no idea how you walked into this hospital. I should be doing lifesaving measures on you."

Dr. Rogers says not only are the signs of heart attack often overlooked in women, research into how to treat them is lacking.

"We''ve excluded women largely, African Americans, Hispanic Americans, Asian Americans, we know very little about how these drugs may interact with their particular kinds of genetic make up."

Now, this wife and mother went on to have a heart transplant. She hopes other women learn from her experience.

"Women don''t have heart attacks like men, we don''t do anything like men," says Mullins-Julson.


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