This I Believe

Rudy - Fort Wayne, Indiana
Entered on October 25, 2007
Age Group: 65+
Themes: equality, illness

An Equal Opportunity Killer

Sara, a 39 year old woman came to my clinic complaining of right-sided back pain. She was very fit and robust, a former college volleyball player who had become a well-respected engineer in the field of water conservancy. Her doctor had recommended a course of powerful pain-killers and that’s why she came to see me. She knew that I rarely prescribed addicting medications.

I performed a neurological exam but nothing seemed amiss. Routine EEG and MRI were negative. I was perplexed about the source of her back pain but decided to air on the side of conservancy and referred her to a cardiologist in the clinic across the street.

By coincidence, Sara and I walked out of my office together. It was lunch time, humid and breezy, and I noticed a few storm clouds on the horizon. I still remember every single unsettling second of what happened next: Sara dropped on the tarmac just beyond the walkway leading to the hospital and clinic buildings. Her eyes bulged and face and neck flushed a bright red as sweat came pouring out of every body orifice. As I dropped to the ground beside her to begin emergency CPR, Sara suddenly threw her head back and balled her fists with startling force. For a split-second, my mind flashed back to the moment when my first wife had given the final, all-encompassing push and my first son was born.

I shouted out Sara’s name as I thrust my hands together on top of her chest and began compressions—one-one-thousand, two-one-thousand … I also shouted to the medical staff coming and going to call 911. The emergency department and all its life-saving technology was less than 500 feet away. My fingers felt for Sara’s carotid artery but it was still. Within seconds, her face had gone from bright red to deep purple to ashen and gray. A pool of sweat spread-out beneath us. I continued CPR until the emergency medical staff arrived but knew that Sara was gone. Her tragic death would change the way I view women and heart disease.

About 50 percent of women have no prior warning before a catastrophic heart attack, but Sara had warning signs. For women, angina—a sign of advanced heart disease—may feel like nausea, shortness of breath, or radiating pain in the jaw or back. Over 250,000 women die from heart disease in the United State each year—that’s more than the 14 leading causes of death combined. Still, heart disease isn’t a standard part of a woman’s health care assessment. As a result, women are often misdiagnosed or never diagnosed. Sara taught me that cardiovascular disease is an equal opportunity killer.