When Cindy DeMarco, 32, woke up from a deep sleep with crushing chest pain, severe upper back pain and shortness of breath, she knew something was seriously wrong. But the young, physically fit marathon runner and Army captain attributed her pain to a running injury. It didn't cross her mind that she might be having a heart attack. She took a painkiller and went about her day but her symptoms worsened. It wasn't until 12 hours later that she checked herself into the emergency room. DeMarco admits that her lack of awareness of heart attack symptoms and the loss of time could have killed her. But it was eventually DeMarco, not the doctors and nurses in the ER, who saved her own life. Her doctor said she probably just pulled a muscle, but she insisted on an electrocardiogram test (EKG), a test that identifies irregularities in heart functioning. The EKG indicated she was having a heart attack.

DeMarco's experience is not uncommon. Too many female heart attack survivors say they didn't recognize their symptoms as heart-related, according to a recent study in the January/February 2003 issue of the journal Women's Health Issues. The study examined the attitudes and experiences of 204 heart attack survivors through a telephone survey. In addition to their own lack of awareness, more than half of these women reported their physicians displayed insensitivity and ignorance when discussing heart disease in women. As a result of the inadequate information and support provided by doctors, more than half of these women said they felt depressed and anxious and had a hard time making the lifestyle changes needed to stay healthy. These findings confirm already existing evidence of a larger problem in the American health care system -- a knowledge-gap surrounding the prevalence of heart disease in women. Despite alarming statistics -- one in two women will eventually die of cardiovascular disease -- it is still considered a men's issue. Warning signs in women, including symptoms of cardiac arrest, often go undetected and untreated.