If you’re an American female and over the age of 40, chances are that getting regular mammograms is part of your life. And if it isn’t – it should be! All the jokes about the torture of a mammogram are highly exaggerated. Yes, it’s uncomfortable, but only for a moment. If you’re avoiding a mammogram from fear of pain, stop. I’m the biggest baby on earth, with a pain tolerance of roughly minus 5, and if I can get through it, so can you. It’s nothing. Having your teeth cleaned is infinitely worse.

American women are hyper-aware of breast cancer, to the point where it’s almost becoming trite. Everything under the sun has little pink ribbons on it, or comes in pink, as a reminder of breast cancer awareness. You can’t walk into a grocery or department store without spotting something reminding us to fear what may be lurking in our bosoms. And oh yes… if that encourages you to buy the product because subconsciously you believe it will buy you breast cancer protection good karma points, all the better. Marketing through fear works. Don’t get me started, because that’s not the direction I want to go.

So. Unless you live in a cave, you’re aware of self-breast checks, and mammograms, and hoping not to be one of the unlucky two in ten women who has to face breast cancer. But are you aware of your heart? Because although breast cancer is front and center on the back of most of our minds, it’s actually heart disease that kills more women than breast cancer. By far.

According to WebMD, “Cardiovascular disease, which includes heart disease, hypertension and stroke, is the number one killer of women, according to the American Heart Association. It kills half a million American women each year. That figure exceeds the next seven causes of death combined. Moreover, women are 15% more likely than men to die of a heart attack. And they are twice as likely to have a second heart attack in the six years following the first.”

Part of the issue is that the classic signs of a heart attack – great pressure on the chest, shooting pains down the arm – are more typical of men than women, whose symptoms include fatigue, aches and pains, heartburn and upset stomach. How is anyone supposed to recognize those symptoms as any different than an average woman’s day? Who runs to the emergency room because they’re tired? No one, that’s who.

I think we owe Rosie O’Donnell a debt of gratitude for her public comments about her recent damn-near heart attack. She felt exhausted (who doesn’t) but had a vague feeling that this was a little more exhausted than usual, did some googling, and decided to go to the hospital. One of her arteries, known in men as “the widow maker” for its sudden lethality, was 99 percent blocked and she was immediately rushed to surgery and a stint put in place. But… unlike a lump you’d feel in your breast, heart disease in women is nearly silent. It’s a shadow that quietly comes up and consumes you without warning.

Given the numbers, with heart disease killing more women than the next seven on the list COMBINED, why is it that doctors readily send women for mammograms, but not heart exams? There is new technology that could be detecting heart disease. Why aren’t doctors making use of it? Beyond an EKG or stress test, the standard was an angiogram. But even that doesn’t detect all heart disease. An intravascular ultrasound will. Why isn’t THIS technology being pursued and funded, and made relatively affordable to women? Why isn’t ultrasound being developed that could detect blocked arteries from outside the body? If that avenue were pursued, the cost could be made palatable to the insurance companies. Surely an ultrasound that detects heart disease in advance is infinitely less expensive than heart surgery and all the aftercare that follows.

You can read more about intravascular ultrasound here:

http://abcnews.go.com/Health/HeartDisease/standard-heart-attack-testing-work-women/story?id=14608193#.UDeXi47ntk4

And you can read more about heart disease here:

http://www.webmd.com/heart-disease/guide/women-more-afraid-of-breast-cancer-than-heart-disease

Most important of all, read about the vague symptoms of heart attack in women here:

http://www.womenheart.org/supportForWomen/prevention/questionHeartAttack.cfm

And if those symptoms sound familiar, BE PUSHY. Go to the hospital, or to your doctor, and insist that they check your heart. Don’t let them blame menopause or depression, or try to brush you off with a prescription for Prozac. You can’t trust your medical care to your doctor alone. You have to take some of that responsibility into your own hands.

Thanks, Rosie O’Donnell, for bringing heart attack symptoms and statistics back into the conversation. It’s hard to notices those things amid the flood of pink ribbons.