Manila: The Philippine Heart Association (PHA) on Monday urged the public, particularly women, to be more vigilant in recognizing the "atypical" symptoms of heart failure, such as the sensation of drowning while lying down, which are often dismissed as mere fatigue or stress. It is called orthopnea, when there is a need to use three or more pillows while lying down for easier breathing.
According to Philippines News Agency, in an online forum marking Women's Heart Month, PHA Council on Heart Failure member Dr. Lauren Kay Galindez explained heart failure is distinct from a heart attack. While a heart attack involves a sudden blockage, heart failure (pumapalyang puso) occurs when the heart cannot pump or relax effectively. "Sa babae po, 'yung hingal na may kasabay na parang nalulunod pag nakahiga (For women, a key warning sign is shortness of breath combined with a drowning sensation when lying in a flat position)," Galindez said.
Galindez noted that other symptoms include paroxysmal nocturnal dyspnea or waking up in the middle of the night gasping for breath; bendopnea or shortness of breath when leaning forward, such as when tying shoelaces; and persistent edema or leg swelling (manas) that does not subside even after elevating feet overnight. According to PHA, women's hearts are physically smaller and influenced by unique hormonal changes. The loss of protective estrogen during menopause and complications during pregnancy, such as preeclampsia or gestational hypertension, significantly increase a woman's risk for heart failure.
"Ang pagbubuntis ay nagkakaroon din ng epekto sa puso, peripartum cardiomyopathy (Pregnancy can also impact heart health, potentially leading to conditions such as peripartum cardiomyopathy)," Galindez said. She also warned that treatments for female-specific cancers, like breast or ovarian cancer, can sometimes affect heart function, requiring close collaboration between oncologists and cardiologists.
"Ang smoking po, sa babae, sa mga pag-aaral, mas pangit ang epekto. In general, smoking ay pangit. Pero 'pag halimbawa, babae ka tapos naninigarilyo, menopause ka na, perimenopause ka na, mas talagang pangit (Medical studies indicate that the adverse effects of smoking are more pronounced in women. While smoking is universally harmful, experts warn that the risks are significantly amplified for women who are in the perimenopausal or menopausal stages)," she said. Moreover, women are advised to be mindful of their weight and diet, as obesity and high salt intake can exacerbate heart strain.
The PHA clarified that a heart failure diagnosis is no longer a "dead end" due to advancements in specialized medications and cardiac rehabilitation. "Cardiac rehab really helps in improving their quality of life. It's a specialized form of physical rehabilitation," Galindez said, adding that it also addresses the depression that often accompanies the loss of functional capacity.
The PHA continues to expand its reach through heart failure caravans and dedicated clinics in government hospitals like the Philippine Heart Center and Philippine General Hospital. Health advocates underscored the importance of early consultation, noting that by the time severe swelling occurs, the pressure inside the heart has likely been elevated for some time. "Because of our roles, [at] home, career, lagi tayong strong. Napapabayaan natin 'yung puso natin. 'Pag ganun po, mas lalong guma-grabe 'yung sakit bago natin makita (Because women are often balancing demanding roles at home and in their careers, they tend to prioritize others and neglect their own heart health. Consequently, symptoms are often ignored, leading to more severe complications by the time a diagnosis is made)," she said.
She added that hypertension, the leading cause of heart failure in women, is manageable through medication, diet and lifestyle changes.
