It didn't raise any red flags in Eva Gomez's mind when her doctor informed her she had a heart murmur. In her early twenties and in good health, she had no symptoms. She filed the information somewhere in the back of her brain and went on with her life.
By the time Gomez finally went in for another heart checkup thirteen years later, she was having regular heart palpitations, her blood pressure was climbing and she couldn't carry on a conversation without feeling winded.
A battery of tests revealed Gomez had a malfunctioning heart valve, which caused blood to back up into her heart. As a result, her aorta -- the large blood vessel that pumps blood from the heart to the rest of the body -- was beginning to bulge like an overfilled water balloon. Left untreated, the artery might burst and kill her.
Gomez, who was only 39 at the time she underwent open heart surgery, said she couldn't believe it when she was diagnosed with heart disease.
"As a registered nurse, I had a professional awareness but I will say this much -- Latina women don't think this can happen to them," she said.
Gomez has a point. Minority women are 66 percent less likely than white women to be aware of the risks and symptoms of heart disease according to a study published in the journal Medical Care. Even when they are aware, the study found, they are less likely to try to reduce their risks or seek treatment.
Yet minority women generally have a greater number of cardiovascular health risks than any other group.
More than 80 percent of African-American and 70 percent of Hispanic women are overweight or obese, compared to just 50 percent of white women, CDC statistics state. They also show that a mere 10 percent of minority women have physically active lifestyles and tend to suffer from high blood pressure and diabetes in record numbers.
Dr. Paula Johnson, the chief of women's health for Brigham and Women's Hospital in Boston, said minority women are faced with higher rates of "almost" risk factors as well.
"For example, they tend to have elevated blood pressure that doesn't quite meet the threshold of hypertension and elevated blood sugar that isn't quite diabetes," she said. "These take a toll on the heart."
Adding to the problem, minority women are more likely to experience risk factors and poor heart health earlier than other women, Johnson said. Although a comparatively small percentage of Hispanic women suffer from heart disease -- less than 30 percent -- a University of Rochester study found that as in Gomez's case, they tend to develop symptoms a full decade earlier than white women.
Obstacles to Heart Health
"Language can certainly be a deterrent to diagnosis and treatment because of miscommunications and mistrust of the medical system," said Dr. Malissa Wood, a cardiologist at the Massachusetts General Hospital Heart Center.
If there isn't an interpreter to help doctor and patient communicate, Wood said it's virtually guaranteed that information will be lost. She said she also suspects that many doctors have an unfortunate tendency to label non-English speaking women as hysterical and over-reactors. As a result, care suffers.
Even when language isn't a barrier, culture can be. Black and Hispanic women often ignore nutrition advice when the recommended foods are unfamiliar or pricey or when culturally favorite dishes wind up on a "bad" list. As for physical activity, many have been raised to view exercise as unladylike. In some cultures, it's frowned upon to be seen sweating in front of men.
So What Can Be Done?
Johnson said she believes that the bias against minority women and their heart health starts at the research level. Currently, not enough of them are included in studies to help understand their particular requirements and biological idiosyncrasies.
"There needs to be a stepped-up effort in research that includes a focus on minority women in a robust way," she said. "There's still a significant knowledge gap of their underlying risks and how to decrease those risks."
Wood added that more culturally sensitive programming would also go a long way. Her ongoing HAPPY Heart study and community outreach program delivers a combination of nutrition, exercise and stress management to minority and lower-income women. The first phase included women over 40 to great success.
The next phase of the study will focus on younger women and lowering the cost of the interventions, something Wood said she'd like to see happen in more communities.
Gomez agreed. Thanks to great medical care, she said, her heart is now in tip-top shape. Her heart no longer races and her blood pressure is at normal levels. A few weeks ago she climbed to the top of the 50-story Prudential Tower in Boston as part of Brigham and Women's ClimbCorp. Program and felt she could keep going.
She said she'd like to see prevention, diagnostic and treatment programs start earlier when they have a better chance of helping women like her avoid major issues later in life.
"We think it cannot happen to us. We think it happens to the older folks, to the abuelas, but that's not always the case," she said. "We have to work towards changing this idea and we have to embrace that awareness."
Tweet Chat: Women's Heart Health
To raise public awareness about heart health for all women, Dr. Richard Besser, ABC News' chief health and medical correspondent, will host a one-hour tweet chat on Twitter today from 1-2 p.m. ET. Want to participate? Here's how. Follow the conversation or jump in with comments and questions of your own.
Medical experts from the American Heart Association, National Blood and Lung Institute, Go Red, the Mayo Clinic and others will join Besser on the chat to answer your questions and offer advice. A special guest, Olympic gold medal gymnast and Go Red spokeswoman Gabby Douglas, will also be tweeting.