Heart disease is the leading cause of death in the U.S., and it makes up one-third of deaths in women. Not everyone knows that women may experience unique symptoms when having a heart attack, and even doctors often mistake them for something else. Bonnie Arkus, founder of the nonprofit Women’s Heart Foundation, learned the lesson the hard way. “When I was 34 years old, my mother had a heart attack while she was on the phone with me on Mother’s Day,” Arkus said.

Arkus was three hours away in Trenton at the time of her mother’s heart attack. Her mother was afraid to go to the hospital alone, so Arkus told her to take aspirin and go to bed until she could get there to help her. By the time Arkus arrived her mother had already gotten to the emergency room with the help of her aunt.

It turned out that Arkus’ mother needed to have an emergency bypass surgery. Sadly she died during surgery.

“It was a complete shock to all of us that she had heart disease! We thought she had panic attacks,” Arkus said.

That was in 1986. Shortly thereafter Arkus founded the Women’s Heart Foundation, which encourages doctors, nurses, and surgeons to learn more about the differences of heart disease in men and women. Its aim is to prevent misdiagnosis of heart attacks and heart disease in women.

“My motive was that my mother had died from heart bypass surgery. There was no data collected on heart disease and outcomes and what could help them survive,” Arkus said.

Raising awareness and educating people about the unique symptoms women may experience with heart disease or when having a heart attack and how to survive is the first step to reducing the number of misdiagnosed women, Arkus believes.

When the foundation kicked into gear in 1992, Arkus was on a mission to bring women into the equation of heart disease prevention. Diagrams and pictures of heart attack patients were all of men, which made women feel as if they would never have to worry about experiencing it themselves.

Even the terminology suggested that only men have heart attacks, Consider the term “widowmaker,” which refers to the left anterior descending (LAD) artery. It implies that only men die from heart attacks due to blockage in this major artery, making widows out of their wives.

The nickname could also be “widower-maker.” Heart attacks caused by the LAD artery can happen to women just as easily as they can happen to men. Arkus’ mother, for example, had a blockage in the left main artery, which connects to the LAD artery, the largest artery leading to the heart that supplies the front wall and some of the side wall of the heart with blood. Blockage in any artery that leads to the LAD artery can be fatal and can cause a heart attack very quickly.

Artery blockages can be treated by placing stents to allow blood to flow through, but unless this happens shortly after the heart attack, it is likely that the victim will die.

Most women may not be aware that they could experience completely different symptoms, so the first thing Arkus and the Women’s Heart Foundation did was assemble a board of doctors, nurses, and advisors to recreate those pictures of heart attack victims and develop gender specific guidelines for what to do in the case of a heart attack.

One of the biggest reasons women are so often misdiagnosed when they have heart disease, Arkus said, is the lack of understanding about the biology of heart attacks and how the plaque collects differently. In men, plaque collects in clumps on the artery walls, making it easy to detect. In women, plaque is distributed more evenly, making it more difficult to detect that the built up plaque is there.

Since heart attacks must be treated so quickly — and sudden death is more common in women — it is important that women be able to recognize symptoms right away and not waste any time getting to a hospital.

It is common for women to not experience any chest pain at all when having a heart attack, which leads them to believe that what they are experiencing is indigestion or stress. Women who are having a heart attack may experience shortness of breath, light-headedness or dizziness, indigestion, upper back pain and fatigue, and it is not uncommon for some women to think they are coming down with the flu. These symptoms differ from some of the obvious signs of a heart attack in a man, such as pain, tightness, or pressure in the chest, pain shooting down one or both arms, and jaw or back pain.

Diagnosis of heart disease is often different in men and women as well. Doctors don’t immediately recognize a heart attack in a woman as they would in a man because most women don’t experience the severe chest pain or have the obvious changes in their EKG patterns men do. According to the Women’s Heart Foundation website (www.womensheart.org), exercise stress test results are misleading in about 35 percent of women.

Arkus said that women need to be their own advocates and be aware of the symptoms of heart disease and heart attacks in order to do something about it, and she has made it her mission to educate women and doctors and raise awareness of the differences.

“I think we need to institute this curriculum of gender specific medicine into the learning of doctors and nurses. They need to have it in their training,” Arkus said.

Arkus, originally from Adelphi, Maryland, hadn’t always thought she would work in the medical field. She had primarily wanted to be a mathematician, but her friend’s mother was a nurse and saw potential in her to succeed as a nurse and encouraged her to pursue it as a career. At the last minute, Arkus changed her career path and went to the Washington Hospital Center School of Nursing for a three-year diploma program.

She was the first in her family to go into the medical research field, as her mother had been a secretary to the adjutant general at the Walter Reed Army Medical Center discussing benefits for veterans with disabilities, and her father was in the meat business. As well as the founder and executive director of the Women’s Heart Foundation, Arkus was a nurse and a Consumer Member of FDA Cardiac and Renal Drug Advisory Committee.

Arkus met her husband, Walt Arkus, in Washington, D.C., while he was in the military, and they got married while she was still in nursing school. They moved to Trenton to be close to his family. Walt Arkus, now retired, was an environmental engineer with the state Department of Environmental Protection, and also was a trustee at the Women’s Heart Foundation and helped with volunteer work for the Teen Esteem program.

The Arkus’ have two children, a son who is a mechanical engineer and works on electric vehicles in Ohio and has children of his own, and a daughter who works for the television program HTVTV in Tennessee.

Arkus and the Women’s Heart Foundation continue to reach out to the community through education and fitness programs, and they provide information and support for women and children who could be at risk for heart disease.

The health of children is just as big a concern for the Women’s Heart Foundation. Being active and getting healthy as a teenager or younger is a big step toward preventing future heart disease. Obesity and diabetes are two major causes for heart disease, and the foundation is taking steps to reduce childhood obesity by providing programs and events to encourage kids to eat healthy and exercise regularly.

“We are constantly looking for ways to incorporate wellness in a community,” Arkus said. She said that she would love to get a program running at Mercer County Community College. Her plans for the future include providing programs to community and local colleges, and possibly getting connected to Michelle Obama’s Let’s Move program. She said that she is hoping the foundation can get more involved with community wellness and collecting data for students with risk factors. The foundation plans to continue to educate, support, and advocate for research of diagnosis and treatment of heart disease.

Arkus said that as soon as the foundation gets more funding she plans to expand the board, get community colleges involved, and reach out to the public through more social media.

“Our primary goal is to have our website be mobile friendly,” Arkus said. A mobile friendly website will help the foundation expand and reach more people, ultimately spreading awareness and providing information to those on the go.

The Women’s Heart Foundation has made progress by providing education, programs, and support, and has plans to expand to reach more of the community. Arkus and the foundation strive to encourage women to advocate for themselves and inspire healthy eating and exercise habits in women and children, and every step they have taken to prevent heart disease has made a positive impact.

“I honor my mother this way and all mothers, and I want to continue to do this as long as I am on this earth,” Arkus said.

Women’s Heart Foundation, 125 Hovey Avenue, Suite 1-D, Hamilton 08610. 609-771-9600. www.womens­heart.org.

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