Don’t miss a beat—untangling truth from folklore may well help keep your ticker ticking.
Myth 1: You’ll know it if you’re having a heart attack.
Myth buster: While some heart attacks do trigger classic symptoms (crushing chest pain, arm pain, difficulty breathing), you may only feel a heaviness in your chest or notice subtle signs such as dizziness, indigestion, nausea, fatigue, jaw pain, and headache. While chest pain is the most common symptom for both men and women, “women are more likely to also have these vague symptoms,” says Tamara Horwich, M.D., medical director of UCLA’s Cardiac Rehabilitation Program. A few reasons you might not recognize what’s going on: Symptoms may come and go, and heart attacks and panic attacks can feel similar. In addition, if you have diabetes you are more likely to have no symptoms or only mild or atypical ones. “Nerve damage from diabetes can cause the signals to manifest as pressure and severe shortness of breath instead of actual pain,” says Sudip Saha, M.D., a cardiologist with Kaiser Permanente in Northern Virginia. The bottom line: If you notice anything abnormal between your navel and your nose that you can’t explain, or you simply “feel like” something is wrong, don’t drive yourself to the ER—call 911.
Myth 2: Young and/or slim people don’t have cardiovascular disease (CVD).
Myth buster: Neither factor gives you a pass. While CVD is more prevalent with age, the most recent info from the National Heart, Lung, and Blood Institute shows that around 20% of 20-to-39-year-old women and almost 34% of men in the same age range have some kind of CVD. “Coronary artery disease, the most common cause of heart attack, takes a long time to become severe, but it can start in your 20s and 30s,” says Adam Kisling, M.D., outgoing chair of the Fellows-in-Training Council of the American College of Cardiology. Weight alone is not a big risk factor. The issue is visceral fat, which surrounds the internal organs and has more adverse effects on the cardiac system than does the outer layer of fat—and thin people may have it. That’s why we all need to live in a heart-healthy way: Stay on top of maintaining good diet, exercise, and sleep habits.
Myth 3: Menopausal hormone therapy raises the risk of heart issues.
Myth buster: Not for most women, according to what we now know. The exceptions are important, though: If you’ve had a heart attack or other heart issues, you may not be a candidate for hormone therapy (HT), which is usually a combination of estrogen and progesterone. Certain types can increase the risk of clotting in the legs and lungs. Timing matters too. “HT has been associated with elevated risk of heart attack and stroke, particularly in older women beyond 10 years after menopause,” Dr. Horwich says. If you are over 60 or reached menopause 10 or more years ago, have a detailed conversation with your doctor, who can factor in your family history and other risk factors. But “if you’re under 60 and within 10 years of menopause, research shows that hormone therapy doesn’t independently increase your risk of cardiovascular disease or heart failure,” says Dr. Kisling.
Myth 4: If you develop A-fib, it will be obvious.
Myth buster: Another challenge in diagnosing A-fib is that symptoms can come and go, and an ECG can pick it up only if it is present at the time of testing. That’s why it’s crucial to share anything that feels off with your doctor. If they suspect A-fib, “they’ll prescribe you an ambulatory heart rhythm monitor to wear, which will be able to detect it,” says Dr. Kisling. Smart watches and smart rings can’t diagnose A-fib but are sensitive enough to detect an irregular heartbeat. “If you get a notification of an arrhythmia from your device, it’s not an emergency, but follow up with your doctor to review the findings,” he adds. A-fib can be managed with medications or procedures that regulate heart rhythm.
Myth 5: Alcohol is heart-healthy, especially red wine.
Myth buster: That said, for people with no heart disease risk factors, moderate drinking isn’t likely to be dangerous. That means having up to one drink a day for women and two for men. But if you have heart disease (or an increased risk of cancer—alcohol ups the risk of at least seven types, including breast and colorectal cancer), talk to your doctor. “For patients with a history of A-fib or heart failure, I preach abstinence,” says Dr. Saha. “Alcohol is a direct toxin to the heart and can trigger these conditions.”
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