Rosie O'Donnell's Heart Attack

Talk show host Rosie O'Donnell, 50, announced  she had sustained a heart attack that required treatment with a stent. At first she thought she pulled or strained a muscle. It wasn't until she felt nauseous and clammy that she realized something might be wrong. As she wrote on August 20th:

“a few hours later my body hurt,  i had an ache in my chest, both my arms were sore, … the pain persisted, i became nauseous, my skin was clammy, i was very very hot, i threw up”

She took an aspirin (good decision!), but didn't call a doctor ubtil the next day (bad!), when it was discovered she had a heart attack due to a 99% blocked left anterior descending (coronary) artery (LAD). She was treated with a stent and is now apparently doing well. Heart disease in women is often left undiagnosed for a variety of reasons, some of which include atypical symptoms such nausea and fatigue. rather than chest pains.

As I have written before:

"Although Coronary Artery Disease (CAD) is often thought of as a problem for men, more women than men die of heart disease each year. Women are six times as likely to die of heart disease as of breast cancer. Heart disease kills more women over 65 than do all cancers combined.

The most common symptom in both women and men is chest pain. But for women this may not be the most prominent symptom. "Chest pain" may feel like a burning, tightness, pressure or some other sensation. A better word than “pain” might be “discomfort.” This discomfort may radiate, or seem to originate, in the jaw, back, mid-stomach or either arm.

One of the distinguishing factors between women and men is that women tend to report more associated symptoms. These may include classic symptoms such as shortness of breath, nausea and vomiting – but may also include several less classic symptoms including fatigue, dizziness and palpitations."

In the media this blockage has been incorrectly called a "widow maker", a lesion that ivolves the Left Main coronary artery, rather than the LAD that is its extension. Apart from much needed attention her cas brought to an often missed diagnosis, It is not at all certain Ms. O'Donnell received the right treatment. Since she was not diagnosed or treated until 24 hrs later, medical therapy alone probably would have been equally effective, less expensive, avoiding the potential complications of stenting. Only in a case of an acute heart attack - and then only if treatment is completed within an 8 hour window following the onset - is stenting superior: A study, "Primary PCI for Myocardial Infarction with ST-Segment Elevation" is one one of many to have shown that stenting offers no long-term survival benefit except in rare cases (“acute coronary syndromes, STEMI, and non-STEMI).