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WOMEN AND HEART DISEASE

By Audrey Sernyak, M.D., F.A.C.C.

Heart disease is the number one killer of women. All too often women are not taken seriously by health care providers and they do not take their own problem seriously enough.

More common than you may think

  • More than 42 million women are currently living with some form of cardiovascular disease. More than 8 million women have a history of heart attack and/or angina.
  • Five and a half million women will suffer angina.
  • Cardiovascular disease claims 2 times as many lives as all cancers combined.

Who is at-risk?

  • Cigarette smoking results in a 2-3 times increased risk of dying from heart disease.
  • 48% of adult women have a total cholesterol of at least 200mg/dL.
  • 50% of Caucasian women, 64% of African-American women, 60% of Hispanic women, and 53% of Asian/Pacific Islander women are sedentary and get no leisure time physical activity.
  • 58% of Caucasian women, 80% of African-American women, and 74% Hispanic-American women are overweight or obese.
  • Women with diabetes are 2.5 times more likely to have heart attacks.

Risk factors

  • Family history of early heart disease (Father or brother had a heart attack before age 55, mother or sister had a heart attack before age 65)
  • Age greater than 55
  • Race/ethnicity
  • High Blood pressure
  • High cholesterol
  • Smoking
  • Diabetes Mellitus
  • Physical inactivity
  • Obesity

Symptoms

  • Discomfort, tightness, uncomfortable pressure, fullness, squeezing in the center of the chest lasting more than a few minutes, or comes and goes
  • Crushing chest pain
  • Pressure or pain that spreads to the shoulders, neck, upper back, jaw, or arms.
  • Dizziness or nausea
  • Clammy sweats, heart flutters, or paleness
  • Unexplained feelings of anxiety, fatigue or weakness - especially with exertion
  • Stomach or abdominal pain
  • Shortness of breath and difficulty breathing

Most important is that women do not ignore their symptoms. Symptoms that come and go can be evaluated with a trip to the family doctor or cardiologist. Symptoms that come and stay should be promptly evaluated in an emergency room. Only a physical exam, ecg and blood work can truly tell if someone is having a heart attack. Time is heart muscle and you should not delay rapid evaluation.

The most important thing to do if you think you are having heart attack symptoms is to call 911 and tell them you are experiencing heart attack symptoms. They will send an ambulance to transport you to a hospital emergency room as quickly as possible so a doctor can examine and treat you.

Also, crush or chew a full-strength aspirin (swallow with a glass of water) to prevent further blood clotting.

What is a heart attack?

The heart is a muscle like all the muscles in your body. It requires oxygen to survive and that oxygen is delivered by the arteries that run on the surface of the heart. When these arteries become blocked with cholesterol or blood clot, the muscle cannot receive the oxygen needs and it begins to die. Heart muscle can survive less than 20 minutes without oxygen.

How is a heart attack treated?

How do you test for heart disease?

  • Blood tests: These include multiple types of tests including checking for heart cells in the blood stream to diagnose a heart attack and blood work to check cholesterol levels.
  • Electrocardiogram: These are electrical tracing of the heart which help indicate ongoing heart damage from a blockage or prior heart damage.
  • Chest x-ray: Can be used to locate heart size and evidence of congestive heart failure or cholesterol buildup in the aorta
  • Echocardiogram: An ultrasound test to look at the heart chamber sizes, heart valves, and heart function.
  • Stress testing: Comes in a variety of types including exercise stress testing, pharmacologic stress testing, nuclear imaging, and echocardiographic imaging.
  • Cardiac catheterization: Done via a small tube in the artery in the leg or arm. Use is x-ray and x-ray dye to directly take pictures of the blood vessels feeding the heart muscle and identify blockages. Using the same process, stents and angioplasty can be used to repair blockages.

The most important take-home message for all women is to make sure they take their symptoms seriously. They need to bring their symptoms to the attention of their physicians who in turn must investigate their symptoms. Women must take an active role in her health care and work to control risk factors which they can modify to lower their overall risk. Every day healthy living and risk factor modification is key to decreasing their long-term risk.

About Dr. Sernyak
Dr. Audrey Sernyak is an interventional cardiologist who specializes in angioplasty and stenting the heart and peripheral arteries. She has been with Associated Cardiovascular Consultants since 2008. Prior to joining them, she was in practice in Fort Worth, Texas. She went to University of Virginia for her under-graduate training, medical school at Medical college of Virginia. She completed her internal medicine, cardiology and interventional cardiology training at U.T. Southwestern in Dallas, Texas. She is board certified in Internal Medicine, Cardiology and Interventional cardiology.

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