I spent many years worrying about cancer since my mother died from ovarian cancer when she was 45 years old, and her mother died from breast cancer when she was just 35. But I never gave much thought to heart disease. That, I believed, was a man’s disease. I am 72 years old, physically fit, with blood pressure and cholesterol that always have been super low, and I walk three-to-five miles daily.
Then, in the spring of 2023, for no apparent reason, I started coughing non-stop. It was a dry, unproductive cough that at times left me doubled over and had me apologizing to anyone within earshot for the racket I was making.
I ignored it for a few weeks, thinking it would go away, and then went to see my doctor, who chalked it up to asthmatic bronchitis. With oral prednisone and an inhaler, the cough simmered down — briefly, before coming back with a vengeance.
I went back to ignoring it.
A year went by, and I saw a different doctor, who put me on Flonase, an anti-allergy nasal spray. “Sometimes older people get a cough,” she said.
Still, the cough persisted, and more doctors’ visits followed. The pulmonologist I saw promised to throw everything, “including the kitchen sink,” at it. Suspecting it was asthma, he put me back on albuterol and Flonase.
I am a violin teacher, and many of the parents of my students were concerned about my persistent cough. One of the parents, a doctor, said to me, “You’re going to give me a heart attack hearing that cough.”
My visits to doctors continued to see-saw back and forth. A CT scan of my lungs did show some abnormalities, a cloudy area at the bottom of my right lung referred to as “ground glass.” An ENT also thought I had asthma, but also acid reflux, and she put me on a restricted diet to guard against gastroesophageal reflux disease — an unwelcome change since, as a pescatarian, I already adhere to a limited diet.
More medications were added to my growing list.
After a summer vacation with our extended family, during which my cough continued to make itself alarmingly evident, I went back to the doctor. During the visit, I remarked somewhat offhandedly that there was a history of heart disease on both sides of my family. “Let’s get you checked out by a cardiologist,” she said. I made an appointment at UCLA for the next available date, which was a few weeks later.
In the meantime, I mentioned to a new student’s mother, Megan Kamath (MD ’11, FEL ’18), who is a cardiologist at UCLA and assistant clinical professor of medicine in the David Geffen School of Medicine at UCLA, that I would be seeing someone in her department in a couple of weeks. “Would you mind if I got you in sooner?” asked Dr. Kamath, who is an advanced heart failure specialist. “Why the rush?” I responded. “I’ve been wondering if your cough is connected to a heart issue,” she said.
Things evolved quickly from there. A CT scan of my heart revealed an abnormality, and the doctor put me on a statin medication. I then had a stress test, which I was told would last about an hour. “Do you have any chest pain?” I was asked a few times. “None,” I replied. Suddenly, the test was stopped, which I took as a bad sign.
A couple of hours later, while I was teaching, I got a call to say that the test was abnormal, and that I should immediately start taking baby aspirin and double my dose of statins. I was in shock. I didn’t think I’d have a heart condition; I was always waiting for the shoe to drop with cancer. An angiogram to view the coronary arteries was scheduled, which revealed a severe blockage, 90-to-99%, in one of the major arteries.
Even though I was still coughing my head off, I now had greater concerns occupying my thoughts.
On September 17, I underwent an angioplasty, during which a slim catheter was threaded through a blood vessel and a stent placed to open the blockage in my heart. As my husband and I drove home from the hospital that same evening, I suddenly realized that my cough was — gone! Not diminished, but completely GONE.
Here’s what I’ve learned: Women can experience symptoms of coronary artery disease very differently than men. A persistent dry cough, for example, can be a symptom that may be more prevalent in women. When none of the medications or special diet prescribed for my cough had any appreciable effect, no one until Dr. Kamath considered that it might be associated with heart disease.
I am fortunate that I didn’t have a heart attack, and I’m spectacularly lucky to have a student clientele that includes some doctors among the parents. And I am especially fortunate to have one parent in particular, a cardiologist who once before had a patient with a terrible dry cough that turned out to be the warning sign of a heart problem.
But not every woman with heart symptoms is so lucky. More needs to be done to educate both medical professionals and the public at large about the ways that heart disease can present differently in men and women. Even though I have a history of heart disease in my family — both of my grandfathers died from heart disease, and my father suffered his first coronary when he was 58 and then had two more — I never thought it might affect me. It was, after all, a man’s disease, or so I thought. Since my own experience, I’ve discovered that my maternal aunt also had serious heart disease.
I hope that one day there will be a test for women who are at high risk for heart disease. But it can be a slow evolution: The pap smear, a test for cervical cancer, was invented in 1928, but it didn’t become widely used until 1960.
Today, I am very grateful to be alive, and I am indebted to everyone who helped me — particularly to Dr. Kamath. I just hope that other women have an easier time than I did getting heart healthy.
Constance Meyer is a veteran session musician who has played on numerous film soundtracks and on recordings with such musicians as Jennifer Lopez and The Jacksons and live orchestral performances with Tony Bennett, the Kirov Ballet, ABT and Joni Mitchell.