The nation annually observes American Heart Month during February to raise awareness about heart disease as the leading cause of death among Americans, especially women. Additionally, Americans recognize the first Friday in February as National Wear Red Day, focused also on increasing public knowledge and sentiments about heart health.

Hollyanne Milley, a cardiac nurse and the wife of Joint Chiefs of Staff Chairman Army Gen. Mark Milley, observed American Heart Month with a visit to Walter Reed National Military Medical Center (WRNMMC) earlier this month to interview two Navy cardiologists, Navy Cmdr. (Dr.) Lauren Weber and Navy Lt. Cmdr. (Dr.) Scott Hopkins about heart health.

“It’s American Heart Month, and as a cardiac nurse, this is a topic that’s near and dear to my heart,” said Milley, a nurse for more than 33 years. According to the Centers for Disease Control and Prevention (CDC), one in three women are diagnosed with heart disease annually, and more than 800,000 people experience a heart attack every year, or about one person every 40 seconds,. 

Milley visited WRNMMC to discuss several issues regarding cardiovascular disease, including how to prevent heart disease, risk factors for heart disease, and signs and symptoms of a heart attack, which can differ between men and women.

MILLEY: What are some of the general topics you discuss with your patients regarding heart health?

HOPKINS: I let patients know how serious cardiovascular disease is in the United States, and then I like to talk to them about their individual risks. We discuss how cardiovascular disease is the leading cause of death in the United States and one of the leading reasons why people come into emergency rooms and hospital settings. A lot of the individual risks are driven by the patient’s genetics, but most of it concerns the patient’s age and sex. On top of that, we discuss other risk factors that would feed into a risk calculator. We delve into how we can change those risks to prevent people from having heart disease.

MILLEY: I frequently hear the terms, “Know your numbers.” What does that mean?

HOPKINS: The “Know your numbers” campaign encourages people to learn their numbers related to cholesterol, blood pressure, blood sugar, weight and body mass index (BMI), to raise awareness, increase detection of cardiovascular disease and diabetes, and encourage people to make healthier lifestyle choices.

MILLEY: What have you observed regarding the signs and symptoms for heart attack in men and women?

WEBER: The biggest sign people think about is chest pain, but I would like to change the word “pain” to “discomfort.” Most patients come in with pain discomfort, such as a tightness, squeezing or even pressure in the chest. Although women have more atypical symptoms, their most common symptom is still going to be chest discomfort. The other thing I want women to be aware of is if they feel short of breath or have arm or shoulder discomfort, those can be symptoms of a heart attack and should be taken seriously.

MILLEY: Can general fatigue in women without presenting discomfort be a sign of a heart attack?

WEBER: Absolutely. I think one of the easiest symptoms to write off, because we are all terribly busy, is fatigue. The thing is if something big has changed, such as now you are more tired than you usually are, or you are shorter of breath than you have been, those should be a red flag that you should come in and see your doctor or seek emergency medical care. If you are feeling anything that feels severe and is not going away, you should call 911. If you have a symptom that has been on and off for a couple of weeks, make an appointment with your doctor.

MILLEY: Statistics show every 40 seconds someone in the United States suffers a heart attack, and most of those occur outside the hospital setting. This shows the importance of knowing CPR and intervention. Can you elaborate about this?

WEBER: I think a lot of people do not know CPR, but it is an important way you can provide impact to your community. Even just being able to push on someone’s chest effectively can help get that person to the hospital alive. For those who do not know CPR, I tell them, “Don’t freeze.” The person who is going to pick up the phone and call 911 and get the emergency medical services on the way often makes a huge difference in saving the person’s life.

MILLEY: What are some actions people can take to reduce their risk of heart disease?

HOPKINS: First, people should know their risks. Then they should be open to taking actions to reduce their risks. If it is high blood pressure, they should be on high blood pressure treatment. If they have high cholesterol, they should be on cholesterol lowering medicine. If they have diabetes, they should be on diabetic medication. It is also helpful to do lifestyle modifications. If you’re sedentary, start an exercise program, or possibly increase it if you are already on one. Eat a heart healthy diet. Do not ever start any tobacco product or stop if you are using them. If you use alcohol, do so responsibly and in moderation.

MILLEY: When would a person go see a cardiologist if there is not an underlying cardiac disease?

WEBER: Heart attacks get the attention, but there are other heart concerns just as important. This is especially true for our younger population. Things I tell people to be on the lookout for are palpitation, such as if you feel an abnormal heartbeat, especially if it is happening more than 30 seconds and a couple of times a week. Also, if you are fainting during exercise, that is a big red flag symptom to me as a heart doctor. We have a lot of tools in our toolkit in cardiology, so you may get an EKG for an electric snapshot [of the heart’s activity], or an echocardiogram [an ultrasound of the heart].

MILLEY: Can you talk about pregnant women as a population for seeing a cardiologist during their pregnancy?

WEBER: When we talk about heart disease and women, especially young women, it may not be related to a heart attack or coronary artery disease. When women are pregnant, this is a particularly important time in their lives when they are potentially gaining risk factors for future cardiovascular disease. There is potential of high blood pressure related to being pregnant, and diabetes related to being pregnant also, so it is especially important for women to go see their doctors and maybe even a cardiologist. 

MILLEY: Thank you both for this especially important information. It is great information for people to explore and know not only during American Heart Month, but every day of the year.

For more information about heart disease, visit the CDC website.