What You Need to Know About Cardiac Disease Following Lisa Marie Presley’s Death at 54
Lisa-Marie Presley at the 80th Annual Golden Globe Awards, two days before she died of cardiac arrest, Beverly Hills, Jan. 10, 2023. Photo: Joe Scarnici/Getty Images for Icelandic Glacial
When Lisa Marie Presley died at the age of 54 last month, people were shocked that cardiac disease could be the cause of sudden death for a seemingly healthy middle-aged woman. She died less than two days after an appearance at the Golden Globe Awards.
There’s speculation that her unsteadiness while on camera, and the stomach upset she was experiencing that day, may have been symptoms of the cardiac dysfunction that ended her life.
Manitoba teacher Michelle Logeot was only 51 when she experienced weakness and fatigue and was sweating a lot for months. “I was told I had anxiety, depression, menopause, a cold, flu, pneumonia, a prolapsed vagina, kidney stones.”
No one would take her concerns about the possibility of cardiovascular disease seriously.
After she survived cardiac arrest — “I flatlined,” she says — Logeot underwent a procedure to open three arteries with stents.
“You have to advocate for yourself and if you have a doctor who dismisses you, then you have to find another one who will help,” advises Logeot.
These experiences are typical for women with cardiovascular disease, the No. 1 cause of death in Canada for women over the age of 55.
University of Alberta research shows that 78 per cent of cardiovascular symptoms are missed in women because they present with at least three additional symptoms over and above chest pain and discomfort compared to men. Women can also experience a heart attack without chest pressure, warns the Heart and Stroke Foundation. Among the symptoms women may experience:
- Shortness of breath
- Pressure, pain or discomfort in the lower chest, upper abdomen, neck, jaw or shoulders
- Indigestion, heartburn, nausea or vomiting
- Dizziness, lightheadedness or fainting
- Upper back pressure
- Extreme fatigue
- Sweating, including cold sweats
Of the women who are sent home from emergency departments annually in Alberta, 300 of them will return within 30 days having suffered a heart attack. Furthermore, the research found that, of 450 emergency departments across Canada, only one has a female-specific protocol for women presenting with cardiovascular symptoms.
A Female Focus
With the arrival of February and Heart Month, the focus this year of the Heart and Stroke Foundation of Canada is women. It’s about time that women were front and centre when it comes to cardiovascular disease, say experts in women’s health. Gaps in research, diagnosis and care are threatening women’s lives, warns the foundation.
“Women weren’t included in clinical trials and the data and guidelines for heart disease and heart attacks are based on clinical trials,” explains University of Alberta associate dean of research and nursing professor Dr. Colleen Norris, Cavarzan chair in Mature Women’s Health at the University of Alberta.
“We don’t even have the clinical evidence to support what treatments work for women,” she says. “We’re still working on diagnosing women’s heart health. We’re still working on being able to identify the symptoms.”
The data on diagnosis and treatment may be missing but the data on misdiagnosis and death are telling:
One in two Canadian women who experience a heart attack have their symptoms go unrecognized. As well, the number one cause of premature death in women in Canada is heart disease and stroke.
More heart research needs to be done in relation to a women’s life cycle, through peri- and menopause, says Norris.
The female disadvantage when it comes to heart disease is that the emphasis on research has always been constrained to obstetrics and gynecology, she says.‘’Bikini medicine’ is the term Norris uses for the focus on women’s health. “Parts of a woman that can be covered by a bikini.”
But the fact that’s been ignored in research is that women’s hearts and other organs are different down to the cellular level and research findings that apply to men don’t automatically apply to women.
Lifestyle and Heart Health
Another contributing factor to older women’s vulnerability to cardiac dysfunction, not widely recognized or studied until recently, is their social situation.
Among older adults, the majority of whom are women, loneliness is associated with increased risk for elevated blood pressure and atherosclerosis, and increased risk of coronary heart disease, stroke, cardiovascular mortality and premature death.
In Canada, one in four older women report feeling lonely at least some of the time, a feeling that may increase during winter months.
Another risk factor for cardiovascular disease, especially for middle-aged women, was the stress level at home, says Norris.
Her research looking at all the stressful factors associated with poor heart health — housework, caregiving, number of children, income, lack of emotional support at home — found that the higher the stress score, the more likely someone was to have a second heart attack.
“Trying to manage a household and continue to function, that was one of the main predictors,” she says. “If you’re highly stressed, always in fight or flight mode, with the stress hormone cortisol streaming through your body at high levels that don’t recover, this can cause damage to the cardiovascular system.”
Her University of Alberta colleague cardiologist Paoli Raggi explains, “The emotional response of women to stress may be one of the causes of their predisposition to more complications once they develop coronary heart disease.”
Ways to Advocate for Your Health
Here are Norris’ tips on how women can advocate for themselves to get the health care they need:
Make Your Health a Priority
“It’s like the oxygen masks on an airplane,” says Norris “You can’t take care of those you love if you don’t take care of yourself first.”
Develop a Relationship with Your Primary Care Clinician
Seek out a clinician you trust. This could be a physician or a nurse practitioner, who may have more time and training to address all of the factors that affect your health.
“The medical model is cure; the nursing model is care,” said Norris. “Nurses are educated to address not just the physical but also the whole psychosocial picture.”.
It doesn’t matter so much whether you choose a male or female practitioner, Norris said. What’s really important is that they answer all of your questions.
Your clinician should be asking you lots of questions too, Norris noted. That’s because, like all of us, they have unconscious, innate biases that can get in the way of seeing you clearly.
“The minute you walk into the room, they are guessing at your age, and because you’re female, they’re thinking about what they know happens to females in your age group — so if you’re perimenopausal, they’re thinking you’re more prone to anxiety and depression,” Norris said.
“They will make assumptions about what they know from a medical perspective, before they know anything about your personal history.”
Recognize Stress and Get Help to Alleviate It
A good health-care professional will help you identify stress and how it affects your health and look for ways to manage it.
Find a Community of Support
Norris said there’s truth to the old saying about social support: men stay healthier when they’re married; women do better when they have a friend or a daughter for support.
Be Persistent if You Think Something Is Wrong
“If you think something is wrong, then something is wrong,” Norris insists, and your clinician should be responsive.
Some tips to make sure you are heard:
- Take someone with you who can help brainstorm questions with you and take notes during the appointment
- Make sure you understand all the medical jargon and ask for definitions if you don’t
- Recap as the conversation goes on so you’re sure you understand it all and know what actions will be taken next
- Follow up to be sure you’re getting test results and that prescribed treatments are working
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