Heart disease used to be mainly associated with men. Today, we know better. We also know that heart disease and heart attack symptoms in women often look different than men's. Knowing the signs may save your life.
- Trouble sleeping
- Nausea
- Indigestion
- Discomfort between the shoulder blades
- Dizziness
- Fatigue
Many women still hold to the belief that cancer is their worst health enemy. In point of fact, heart disease kills nearly twice as many women as all forms of cancer put together. Surprisingly, more women than men die each year of heart disease. Of women age 40 to 70, fully 81 percent are at risk for heart disease -- yet only 25 percent have been diagnosed or see themselves at risk. 
Partly because they are unaware of cardiac threats, women tend to delay seeking medical help. They also fail to recognize warning signs, some of which are distinctly different than those of men. In addition to chest pain, shortness of breath or the feeling a heaviness in the chest, women commonly experience nausea, fatigue, indigestion, discomfort between the shoulder blades and dizziness.
Heart attacks occur an average of 10 years later in women, possibly due to higher estrogen levels prior to menopause that may protect a woman against heart disease.
Heart disease is not a single disorder. The term refers to a wide array of conditions, some inherited, but most caused by factors that come into play as life goes on. Types of heart disease include:
- Coronary Artery Disease. This is the most common type of heart disease and the leading cause of heart attacks. CAD occurs when fat and cholesterol clog the arteries that feed blood to the heart muscle. The clogs prevent blood from flowing smoothly to the heart muscle. Oxygen and nutrients needed for the heart to function are in too short supply, and the heart's pumping action can be impaired. Sudden formation of a blood clot over the fatty deposit inside the artery can abruptly close the artery, triggering sudden death or heart attack. In addition to taking medications and making lifestyle changes, patients with CAD disease may undergo angioplasty with stent placement or coronary artery bypass surgery.
Many people with plaque deposits in the coronary arteries do not have any symptoms, and normal or slightly elevated cholesterol. An ultrasound of the carotid arteries in the neck can reveal narrowing or blockage caused by the accumulation of plaque along the artery walls. Known as a carotid intima-media thickness (IMT) scan, this test is a reliable, noninvasive method to evaluate cardiovascular risk without exposure to radiation. Increased carotid IMT is directly associated with an increased risk for heart attack and stroke. Another screening test is the coronary calcium scan, which uses an electron beam CT scanner to view calcium buildup in the coronary arteries, providing an early warning of coronary artery disease before a person experiences any cardiac symptoms.
- Heart failure. This condition is caused by a problem in the lower left side of the heart (left ventricle). The heart muscle becomes too weak to pump effectively and vital organs do not get enough blood. Excess blood remains in the chamber and crowds the blood still coming in from the lungs, causing a backup in the heart and lungs. The heart does not stop pumping altogether; it simply fails to pump the right amount of blood. The body will try to compensate for the lack of blood by increasing the heart rate and retaining salt and water. Depending on the severity of the condition, treatment options include drugs, biventricular pacing (a procedure to improve blood output in the heart), surgery to open blocked blood vessels, and heart valve surgery or heart transplantation.
- Cardiomyopathy. This is a condition associated with abnormal structure and function of the heart muscle. There are several types of this disease, including dilated cardiomyopathy, hypertrophic cardiomyopathy and restrictive cardiomyopathy. Each refers to deterioration of the heart muscle that affects its ability to pump enough blood. Coronary artery disease is a frequent cause of this condition. The condition, which in most cases begins in the lower chambers of the heart, becomes worse over time. The heart may grow in size, or become thick or stiff. Abnormal heart rhythms, heart failure and sudden death can result. Treatment options include medical therapy and -- depending on the cause or type -- angioplasty with stents, bypass surgery, pacemaker and defibrillator, valve surgery and heart transplantation.
- Valve disease. There are several types of valve disease, some of which a person is born with and some are caused by infections, bacteria and other diseases. Four valves in the heart are responsible for ensuring that blood flows without blockage in a forward direction through the areas of the heart. Valvular stenosis occurs when the opening of a valve is too small. Valvular insufficiency means the valve does not close tightly. In cases of mitral valve prolapse, the mitral valve is stretched out. In this condition, as the heart beats, the mitral valve flops back into the left atrium and lets the blood leak backward. Treating valve disease involves medical therapy, and in severe cases, surgically repairing or replacing the valve.
- Congenital heart disease. This develops while a baby is still in the mother's uterus. Congenital heart disease can show up at the time of birth or not until adulthood. Formation of various areas of the heart is abnormal for reasons that are not fully known. The most common problems involve valve defects, malformations of the walls that separate the atria and ventricles, and heart muscle abnormalities. Less severe defects may not require any treatment; others are treatable by medications, surgery, and specific procedures, depending on the severity of the disease.
- Aortic disease and Marfan Syndrome. The aorta is the largest artery in the body. Aneurysms, which are bulges in the wall of an artery, occur when the artery wall develops a weak area and the artery pushes out to develop a balloon-like structure. Aneurysms can occur in the part of the aorta that passes through the lower abdomen as well as the part that runs through the chest cavity. In Marfan syndrome, an inherited disease present from birth, construction of connective tissue is abnormal. As a result, about 90 percent of patients experience changes in the heart and blood vessels which increase the chances of aortic aneurysm and mitral valve prolapse. Regular monitoring is essential to any treatment program. Generally, medications are given. As the disease progresses, valve and/or aortic surgery may be considered.
- Pericarditis. The pericardium is the thin sac that surrounds the heart. When this membrane becomes inflamed, it may cause chest pain. Build-up of fluid in the sac may reduce pumping function of the heart, requiring removal of the fluid using a needle. Chronic thickening of the pericardium may cause constrictive pericarditis, requiring heart surgery. Anti-inflammatory drugs, steroids and antibiotics may be used to treat symptoms of pericarditis.
Many heart conditions can be avoided or take less of a toll by managing lifestyle habits:
- Avoid smoking cigarettes, cigars, pipes or any other form of tobacco
- Eat a healthy diet that includes plenty of fruits and vegetables. Avoid foods loaded with saturated fat.
- Monitor cholesterol to keep levels in the safe range
- Maintain physical activity, such as walking or other type of activity for thirty minutes daily
- Stay at your ideal weight
- Control blood pressure by limiting salty foods and alcohol intake
- Learn stress management techniques
- Women's Heart Program at Cedars-Sinai Heart Center
- Cedars-Sinai Heart Center
- S. Mark Taper Foundation Imaging Center (Coronary Calcium Scan)
