The Heart of the Matter

It takes the average woman in Israel 59 minutes longer to turn for help than a man while having a heart attack—and 89 minutes longer than a man to get to the ER.  When having a heart attack, time is muscle.  The longer it takes before the blocked artery is opened, the more damage happens.

Many fewer women have heart attacks than men, but when they do, it’s much more dangerous. In Israel, a woman’s chance of dying within a month after a heart attack with a blocked artery is 11%, compared to only 3% in men. And the risk is highest in young women-those under 55.

“If we can empower women to seek help in time, rather than deny and defer, we can save lives,” says Dr. Donna Zwas, director of the Linda Joy Pollin Cardiovascular Wellness Center for Women, based at Hadassah Medical Center in Ein Karem.

Yes, it’s that simple. Get help in time – and lives will be saved. Your life, for example. Or the life of someone you love.

That’s why the Cardiovascular Wellness Center for Women, together with the Israel Heart Society and other women’s heart centers throughout Israel – Rabin Medical Center (Beilinson), Tel Aviv Sourasky Medical Center (Ichilov), Rambam Hospital and Sheba Medical Center (Tel Hashomer) – are kicking off Israel’s first Heart Disease Awareness Week campaign to raise awareness about the signs and symptoms of heart disease in women—and galvanize women to seek help. Think of it as the Blue-and-White version of Go Red for Women, the American Heart Association’s signature campaign to raise awareness about women’s heart health.

“We want women to know the signs and symptoms and if they unfortunately experience them, we want them to feel empowered to call for help.” Notably, asserts Dr. Zwas, when we asked women what they would do if someone else was having the signs of a heart attack, 75 percent said they would call an ambulance. When we asked them what they would do if they themselves felt the symptoms, only 54 percent said that they would call for help.

Signs of a heart attack in women include: uncomfortable pressure, or squeezing in the chest that either lasts for a few minutes or goes away and comes back; pain or discomfort in one or both arms, the upper back, neck, jaw or stomach; shortness of breath; cold sweat, nausea, lightheadedness, vomiting. Frequently it is described less as pain and more as discomfort. Often in women, it does not feel like a “Hollywood Heart Attack.”

This national campaign has both the visuals and the celebrities to get the message out. A six-meter red balloon was hoisted up on December 1 in Tel Aviv’s Rabin Square where it will remain until December 5. The heart expands thanks to likes on Instagram and Facebook, using the hashtag #שימילב, a Hebrew play on “pay attention” that includes the Hebrew word for heart. The Pollin Center designed and created a new application to translate likes into puffs of air in the balloon.

Celebrities who are sharing the campaign on their respective Instagram accounts include: actress/comedienne Orna Banai, television anchor Dalia Mazor, gastronomist and television personality Michal Ansky, pop singer Rita, actress Yael Levental, actress/writer Miri Nevo, actor/singer Edan Alterman, Nimrod Harel, actress/entertainer Tzipi Shavit, writer Lihi Lapid, actress Sharon Haziz, actress/comedienne Lital Schwartz, and others.

This campaign can be considered a pioneering effort in the world of health promotion, as the Pollin Center recruited companies that are committed to the health and social welfare of their employees to use their internal communications resources to promote this message to employees. Companies that have participated include El Al, Sano, Regba, Strauss, Bank Hapoalim, Tera, Atmor, the Ministry of Absorption, AEG, Menora, Estee Lauder, and Uniliver. Each company has chosen from a list of options and materials prepared by the Pollin Center to share information with their workforce.

And while folks are ordering coffee and assorted fare at one of the umpteen branches of Aroma Israel coffee shops throughout Israel, they’ll see this video, prompting them to be attuned to heart health.

Dr. Zwas took off a few minutes from the campaign, and checking patients at the clinic, to chat.

Tell me about your center.

The Linda Joy Pollin Cardiovascular Wellness Center for Women was established with the intent of reducing the numbers of women who die each year in Israel from heart disease. That includes improving cardiovascular wellness locally, nationally and internationally through education and awareness; gender-appropriate medical care; community-based health promotion; workplace interventions, and research and advocacy. The Pollin center was established at Hadassah with the generous assistance of Mrs. Irene Pollin of Washington, D.C., a pioneer in the field of women’s heart health who wanted to spread her message beyond the United States. Our center is involved in schools, workplaces, communities, women’s organizations, and more.

How are women’s heart attacks different from men’s?

Women differ from men biologically, and they confront different challenges when seeking health care which may be more related to gender than to biology.

For most women and men, the primary presentation is discomfort of some kind in the chest.  A man may immediately attribute this to heart pain whereas a woman may seek all sorts of different explanations for what she feels. Common  symptoms in women include pain in the shoulders, upper arms, jaw or upper back, indigestion, shortness of breath, sweating and extreme fatigue.

When a man has chest pain, the immediate response is to call for help. When a woman has chest pain, it rarely occurs to her that this may be a heart attack.  Think about the statistic that opened this article: In Israel, it takes women on average 59 minutes longer than men to seek help!  This translates into more damage to the heart, and more disability.

How many women in Israel, and around the world, die of heart disease every year?  Is that the stat still the same that it kills equal to/more than all the cancers combined?

In 2017, approximately 3700 women died in Israel from heart disease, and more than 5000 if we add stroke and other vascular disease. In the world, cardiovascular disease is responsible for 31% of all deaths, in women and in men.  In Israel, because our healthcare system engages in prevention and top-of-the-line treatment, our rates of death from heart disease are much lower, and for men, among the best in the world.

What are the particular challenges of approaching the various populations of women in Israel, e.g., Jewish, Arab, Ethiopian, Haredi, women with disabilities, those with low income, etc…?

Every culture poses unique challenges and unique opportunities.  We work with communities that are themselves committed to health promotion for their members, and they help us adapt our messages and interventions to suit their particular needs.  No matter what community we work in, we need to empower women to make themselves a priority. (Women, repeat after me: you are a priority!)

What does the center do that’s special or different?

Our center is special in the comprehensive and holistic approach that we take to cardiovascular wellness, from the individual in our clinics, the interpersonal through social media, the community through our health promotion interventions, the medical community through medical education, and policy through advocacy.

What’s the vision for the next five years?

We are now working on our strategic plan for the next phase of the Pollin Center.  We hope that this week’s media campaign to increase awareness of heart disease in women will bear fruit, leading women to recognize the signs and symptoms of heart disease, get help quickly – and save lives.  At the same time, we are working in the workplace and in the community to create cultural shifts that promote health and health behaviors. We ask the women in each community what they need and what they want, and help them design the programs that will make sustainable change.  We envision more and more heart healthy communities, and the longer I work in this field, the more I think that it is really possible. I am so grateful for the enthusiasm of our community partners who translate our joint vision into a growing and expanding reality.

How many women have you served/educated since you were established?

We counted 70,000 in 2019, 46,000 in 2018, up from 20,000 in 2017, not counting social media.

Please give one or two tips that can contribute to heart health.

I am continually surprised by the significant impact of small interventions.    We have had amazing success with low-tech pedometers, which help people set clear attainable goals and reach them. The data suggests that dieting ultimately leads to weight gain, and that it’s best to make simple sustainable changes that promote health rather than losing weight and then gaining it back plus some. I often tell my patients to stay away from “white” foods: white sugar, white flour, white potatoes and white rice.   At the same time, it’s important not to feel deprived, as that is simply not sustainable.

This campaign is about empowering women: empowering them with information that they need to care for their hearts, and empowering them to get the help they need when they need it.  If you have chest pain, chest discomfort, shortness of breath or any of the signs of a heart attack, call an ambulance.

We women are the caregivers in our society, and we have to make sure that we care for ourselves as well.

Want to blow up the heart in Rabin Square? Give a “like” on  https://www.facebook.com/WomenHealthyHeart/photos/a.238614296313424/1347593085415534/?type=3&theater or on Instagram https://www.instagram.com/p/B5XGxyMHIIH/?igshid=gi1600pt45lx

Dr. Donna Zwas, director of the Linda Joy Pollin Cardiovascular Wellness Center for Women, based at Hadassah Medical Center in Ein Karem photo credit: Avi Hayun