"I thought I was just really rundown from my daughter's baptism the day before," said Kimet, who lives in Eerie, Pa. "I felt so tired and sick to my stomach. I slept the entire next day away."
Kimet waited three days before she drove herself to the hospital, where she hoped doctors would give her something for her flu symptoms. Instead, they cut open her chest and performed a triple bypass.
"I had no idea I was having a heart attack," said Kimet. "I'd had only ever seen my father have a heart attack, and he was always grabbing his chest. I had no pain in my chest."
Although chest pain or discomfort is the most common heart attack symptom, fatigue, nausea, shortness of breath and pain or numbness in the jaw, arms or back can also signal a blocked artery cutting off vital oxygen and nutrients from the heart. And according to a new study of more than 1 million heart attack patients, women under 55 are less likely to seek medical attention for those atypical symptoms and more likely to die in a hospital from a heart attack than men of the same age.
"Young women who have atypical symptoms might not appreciate that they're in fact having a heart attack and may be more likely to delay treatment," said Dr. John Canto, a cardiologist at the Watson Clinic in Lakeland, Fla., and lead author of the study published today in the Journal of the American Medical Association. "They think it's the flu or stress or a pinched nerve, and they don't want to come in to the hospital only to have doctors tell them it's nothing serious. But we should all err on the side of caution."
Kimet, now 46, takes 30 pills a day for heart failure. The drugs, designed to lower her blood pressure and slow her weak heart, have packed weight on her once fit frame.
"I'm really fat, but I'm still here," said Kimet, whose doctors gave her five years to live 11 years ago.
Since her first heart attack, Kimet has had three more, signaled by a squeezing in her arm, a tingling in her hand and numbness in her jaw. She never had chest pain.
"Less than 20 percent of patients who present to a hospital with typical or atypical symptoms are in fact having a heart attack," said Canto. "But time is muscle and muscle is life. When an artery is blocked, the heart muscle begins to die after 30 to 60 minutes. We call it the golden hour of heart attacks. Every minute you wait after that golden hour, more heart muscle will die. And once you lose it, it's not coming back."
Dr. Malissa Wood, spokeswoman for the American Heart Association and co-director of Massachusetts General Hospital's Corrigan Women's Heart Health Program, said women tend to look out for the hearts of others more so than their own.
"I think women tend to worry so much about breast cancer, and I understand why," said Wood, who has survived breast cancer herself. "But heart disease is the No. 1 killer of women."
Women should "know their numbers" and risk factors, said Wood. Smoking, high blood pressure, high cholesterol, diabetes and a family history of heart disease raise the risk of heart attack.
"The more risk factors you have, the more you really need to pay attention when symptoms strike out of the blue," she said. "It's rare for young women to have a heart attack, but the results can be devastating."
After her first heart attack, Kimet wrote letters to her then 3-year-old son and 2-month-old daughter for every year of their lives, and tape-recorded a special message "so they wouldn't forget me," she said. Two weeks ago, when she had another heart scare, she updated the tape.
"Nobody can replace a mom," said Kimet, voice shaking, whose children are now 14 and 11. "Luckily, I can put away those letters and the tape for now.
Kimet said her heart attacks stole her career and her life savings. Now, she's grateful for every birthday and hopes to be there for her kids' milestones.
"I feel so bad that they have to grow up with a sick mom," she said. "I'm trying to fit in a lifetime with them right now. Every year is a gift."