“Just Menopause.” Two Words That Cost My Mother Her Life

Women’s Heart Health Month ends this Saturday. It goes out with two things worth your attention — a major new study showing young women are dying of heart attacks at rising rates, and a truth that’s older than any study: doctors are still dismissing women’s symptoms as menopause. I should know. It cost my mother her life.

A major new study published Thursday in the Journal of the American Heart Association analyzed nearly a million hospitalizations between 2011 and 2022 and found that death rates from severe heart attacks have been rising among Americans under 55. Not the elderly, where decades of medical advances have made genuine and measurable progress. We’re talking about young people. And the numbers are even worse for women than for men, by a margin researchers say is both significant and preventable.

This one’s personal for me.

My mother died of a sudden, massive heart attack. She was 55. I was 14. She had symptoms beforehand, real ones, the kind that, in hindsight, were pointing directly at what was coming. Her doctors dismissed them. Told her maybe it was menopause. Told her what she was experiencing was hormonal, normal, nothing to worry about. That pain in her arm? “Bursitis.” Her constant nausea? Nothing to worry about, she was just “going through the change.” She trusted them. She went home. She died. Our family was obliterated in an instant on that Sunday morning in ‘79. The wreckage scattered across my life and my siblings’ lives, leaving scars so deep they would never heal.

Ours is not an unusual story. It’s an all too common one. And the research published this week makes clear it’s still happening, decades after my mother died.

What the study found

Researchers analyzed 945,977 first-time hospitalizations. They zeroed in on STEMI heart attacks, the severe kind caused by a complete blockage of a coronary artery, and found in-hospital death rates among adults 18 to 54 climbed by 1.2 percent between 2011 and 2022. Women in that group died at a rate of 3.1 percent. Men at 2.6 percent. That gap doesn’t come from women arriving sicker. The complication rates were similar between the sexes. What wasn’t similar was the treatment. Women received fewer cardiovascular procedures to identify and address the cause of their heart attack. Less intervention. Same severity. Worse outcomes. Women were also more likely to experience cardiogenic shock — the point where the heart can’t push enough blood through the body to keep things running. It’s one of the deadliest complications of a heart attack, and it was showing up more in women than in men with the same diagnosis.

The menopause problem nobody’s solving fast enough

Here’s the part that connects directly to my mother’s story, and to a lot of families who have lived some version of it. Women in their 40s and 50s are moving through perimenopause and menopause, a stretch of life when estrogen declines and cardiovascular risk rises sharply. Estrogen keeps arterial walls flexible and has anti-inflammatory properties throughout the cardiovascular system. As it drops, blood pressure tends to climb, cholesterol profiles shift, and arteries become more vulnerable. The problem is that the early warning signs — fatigue, shortness of breath, jaw discomfort, nausea, a vague but persistent sense that something is off — look almost identical to what menopause already feels like. My mother’s exact symptoms. I can still hear her describing them. Doctors who aren’t looking carefully, or who carry the old assumption that heart attacks are mostly a man’s problem, miss it. They write it off. They send women home.

That’s what happened to my mother. It cost her life. It cost our family everything.

Dr. C. Noel Bairey Merz directs the Barbra Streisand Women’s Heart Center at Cedars-Sinai’s Smidt Heart Institute, which has spent more than two decades trying to close exactly this gap. She spoke publicly about the problem just this week. “Too often, when a young woman has heart disease symptoms, a physician will ignore those symptoms and tell her that she needs to lose weight,” she said. “That’s because heart disease symptoms in women can be very different from what men experience. So it’s crucial that women know what to look for.” Rates of heart disease are increasing in women 35 to 54. They’re still less likely to receive evidence-based treatments than men. And they’re still more likely to be told they’re too young, or too hormonal, to have a real cardiac problem.

Cedars is doing the work

The Smidt Heart Institute received a $7.5 million NIH grant this month for a five-year study examining how small blood vessel damage drives heart disease, cognitive decline, and physical frailty in aging women — conditions that for years got dismissed or misdiagnosed because the diagnostic tools were designed around how men present. It’s called the MAE-WEST HBF study, a nod to Mae West’s line about never being too old to become younger. The research builds on work from the Barbra Streisand Women’s Heart Center that identified microvascular disease, chronic inflammation, and other female-pattern cardiac conditions that standard tests often miss entirely.

Progress is being made. It’s just moving slower than the death rate.

What to actually watch for

Heart disease kills more women than all cancers combined. The American Heart Association has been trying to shift public awareness for two decades through Go Red for Women. The chest-clutching Hollywood heart attack is not the standard presentation in women. What is: sudden unusual fatigue, shortness of breath, nausea or stomach pain, jaw or back pain, dizziness, or just a feeling that something isn’t right that won’t go away. These get dismissed constantly. By doctors. By the women experiencing them. By families who assume it’s something else.

If you’re a woman in your 40s or 50s and a doctor waves off your symptoms as menopause without any real investigation, push back. Ask what else it could be. Ask for a referral to someone who specializes in women’s cardiac care. The Barbra Streisand Women’s Heart Center at Cedars isn’t far. They exist specifically for this.

If you take one thing from this

If there’s one woman reading this — a mother, a sister, an aunt, a daughter, a friend — who has been brushing off symptoms, who has been told she’s too young or too stressed or just needs to lose a few pounds, this is the push to take it seriously. Get the appointment. Ask the questions. Push back if you’re dismissed. Heart disease doesn’t negotiate.

My mother trusted the answer she was given. She didn’t get the chance to push back. You do.