Heart Disease: Is
there a Gender Difference?
By Stephanie L.
Goodwin, DO
As a native of
upstate New York, I was happy to return home to help initiate an important
addition to local cardiac care services: advanced heart-attack care at the
Cayuga Heart Institute.
The cardiac care
team at Cayuga Medical Center offers PCI on an emergency basis to heart attack
patients, to open coronary artery blockages and restore blood flow to the
heart. PCI is also offered as an elective procedure to patients suffering with
chest pain due to coronary artery disease.
In addition to my
interest in interventional cardiology, I am especially committed to treating
women with coronary artery disease (CAD). For many years CAD has been
inadequately recognized and treated in women when, in fact, it is the number
one cause of death for both women and men.
Why does coronary
artery disease go unrecognized in women?
The signs and
symptoms in women are often different from what most men experience. Because
their symptoms may seem unrelated to CAD, women tend to delay seeing their
doctors. What masquerades as stomach problems or difficulty catching their
breath may in reality be heart disease.
What are women’s
risk factors for heart disease?
Women’s risk
factors are essentially the same as men’s but women develop CAD at a later age
because of the somewhat protective factor of estrogen. However, once a woman
reaches her mid to late fifties, CAD becomes much more significant.
Risk factors for
heart disease in both genders are high blood pressure, elevated cholesterol
levels, diabetes, smoking, obesity, and lack of physical exercise. Everyone
should be mindful of these risk factors because they can bring on the need for
diagnosis and therapeutic follow-up for heart disease.
What are the most
common symptoms of coronary artery disease in women?
While women’s
symptoms may include pain in the center of the chest, women more often develop
unusual symptoms that many people don’t typically associate with heart disease.
These symptoms include:
-
Shortness
of breath
-
Discomfort
between the shoulder blades in the back
-
Dizziness
or passing out
-
Nausea
and other digestive symptoms
-
Heart
palpitations (skipping or fluttering or an uncomfortable sensation in the
heart)
Because these
symptoms are under-recognized as being cardiac in nature, heart disease in
women is often discovered later than in men, and it is more advanced.
What steps should
women take if they experience these symptoms?
The caveat to all
women is that if you experience some of these symptoms, it is important to tell
your doctor so you can be tested for CAD. Testing may include an EKG,
echocardiogram (using ultrasound to examine the heart), and stress testing (to
determine how your heart performs during exertion). Depending on your symptoms
and test results, your doctor may recommend cardiac catheterization for a much
clearer picture of the heart and coronary arteries. If this reveals narrowing
and blockages in coronary arteries, there are effective treatment options
(angioplasty and stents or coronary bypass surgery) to open blockages and
restore blood flow to the heart.
All of us should
get our risk factors for heart disease in control. Your doctor can help you
slow the progress of heart disease through proper diet, exercise, and medical
therapy.
Dr. Goodwin is an
interventional cardiologist at the Cayuga Heart Institute. She is board
certified in cardiovascular disease and interventional cardiology, serves on
the medical staff of Cayuga Medical Center, and is in practice with Cayuga
Cardiology of Cayuga Medical Associates, where she can be reached at (607)
269-0100.
