Understanding and publicizing heart disease among women

Last Sunday, a huge balloon of a human heart was placed at Rabin Square in Tel Aviv, this time the goal was the focus of a campaign with the #SimiLev hashtag meant to make women aware of the symptoms indicating heart troubles. The massive human heart and the information booth were on site until yesterday. Members of the public are invited to pump this massive heart by offering Instagram likes until the heart will expand to the height of six meters (19.6 feet). How will this work? Well, each social media like given to the Womens Heart Health Center at Hadassah University Medical Center in Jerusalem's Ein Kerem will be met with some extra air inflated into the huge heart. “We often attempt to get media attention to women's heart issues to increase awareness of the issue,” head of the Womens Heart Health Center, Dr. Dana Tzfat said, “but this is the first time we are attempting a week-long campaign.” Dr. Tzfat is one of the leaders behind the effort, and as she explains it, “We try to get our message across with creativity.” “One part of this creativity is to work with new systems, such as the social media app and the inflatable heart, which were both developed by us,” she said. The campaign is a collective work, joining together the Israeli Association of Cardiologists and four other women's heart health centers in The Rabin Medical Center – Beilinson Campus, Ichilov Hospital, Rambam Medical Center and Sheba Medical Center, Tel Hashomer. The need to promote better awareness among women to possible heart problems is that they are usually thought of as a male health risk. This is why a woman is three times as likely to die as a result of a heart attack than a man. While fewer women suffer from heart failures than men, such heart attacks are deadlier when their victims are women. Women don't seek help as much as they need to when they experience the first signs of heart troubles. “On average,” Dr. Tzfat explains, “women wait 59 minutes before asking for medical help and take an extra 89 minutes to arrive at the ER.” “Every delayed minute,” she warns, “means another heart cell not making it.” The reason for this difference is that when men experience chest pain, “everybody speed dials the emergency services,” she says, “women who experience chest pains try to self-diagnose.” “The woman might convince herself that this can't really be a heart attack, and that the pain just means she is tired, for example,” she says. In a survey, people of both genders were asked what they would do if they experience chest pains. Those who said they would not call an ambulance were asked why, in 27% of the cases, both men and women said the reason was money. They could not afford to pay the ambulance fee if the situation did not require them to remain in hospital. While 74% of women said they would fetch an ambulance if someone else was suffering from pains in their chest, only 54% said they would show the same kindness to themselves and call an ambulance if they had such pains. Dr. Tzfat explains that “women are very much afraid others will call them hysterical.” They also lack the time to look after their own health as they are committed to work, family life, their children, their parents and have little time left over for their own needs. Hence the common reaction of saying that “these chest pains will go away in the morning.” “This is why I am so confident an awareness campaign will help,” she said, “a woman rarely imagines she is having a heart attack. Simply be making that thought an option we will increase the numbers of women seeking medical help at the first sign of such symptoms.” She stressed how vital it is women listen to their own “inner voice,” and pay heed to any minor change, for example, if something that used to be feasible, like climbing two flights of stairs, becomes something they try to avoid. Many think of breast cancer as the global leader in health risks for women, WHHC marketing director Hanna Gratenberg says, but they are wrong. She points out that heart and blood vessels issues are the number one cause of death for women, not breast cancer. “Israeli women are not aware of the risks when matters of heart health are concerned,” she says. Head of the Israeli Association of Cardiologists, Prof. Doron Zeger, says that, in his view, the matter is not indifference, as some women and some men are bound to be indifferent to health concerns – as long as they are healthy – but that women simply do not experience heart problems in the “usual, common classic” way that men do, he points out. Women might show other signs of heart problems, such as shortage of breath and overall poor health, this is common among older women. While it is generally true that premenopausal women show less heart trouble than men, once menopause begins, the numbers even out. “This leads some members of the public to feel a lack of concern, as if heart troubles are only a male issue. This is wrong,” he warns. “I have seen young women get heart attacks as well,” he explains. “This is why this campaign is important, so that everyone will become more aware of the risks.” Dr. Tzfat explains that in this country, the average age for a first heart attack among men is 65 and among women, 72. Women who do not smoke or suffer from diabetes enjoy some measure of defense against heart problems that seems to vanish with menopause. In 2017, 3,900 men died in Israel due to heart attacks and 3,700 women died likewise. This was the first year in which men died in greater numbers from heart attacks than women. Until 2016, women tended to die more often from heart failures. Dr. Tzfat urges all women at risk, meaning women with high blood pressure, high levels of fat in their blood and high levels of sugar, to get checked. “And not just by an EKG machine,” she warns. “Demand to have a cardiac stress test as well.” She lists the other telltale signs that something might be wrong: heart-burn; shortage of breath; pain in the shoulders or upper back or the arms or the jaw; sweating and feeling weakness for no apparent reason. Such campaigns have attempted to raise awareness among women in the US since 1997, but encountered mixed results. While white women were able to benefit from the information, women of color were either not exposed to it or unable to use it to seek help on time. In this country, both men and women in the entertainment industry have agreed to take part in the campaign and include the red inflated heart in their social media accounts: from model Galit Gotman and former children entertainer Tzipi Shavit to Mentalists Nimrod Harel and Lior Suchard, famous for their abilities as stage magicians. The campaign was joined by such Israeli firms as El Al and Bank Hapoalim, meaning that tens of thousands of workers will be able to have access to the information it contains. “We may not be able to change human behavior from one day to the other,” Dr. Tzfat said. “One week can only get so many people to notice things... we need to drive the message home constantly, drop by drop.” Translated by Hagay Hacohen.

Understanding and publicizing heart disease among women

The campaign is a collective work, joining together the Israeli Association of Cardiologists and four other women’s heart health centers.

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