Northwest Health Spring 2012

Heart Disease in Women

Where women are concerned, heart disease assumptions may not apply.

Go to: Northwest Health Index

When movie or television characters have heart problems, they show it by clutching their chests. But in the real world, it's not always so easy to diagnose heart disease and it's especially difficult in women.

"Women with heart disease often present with atypical symptoms," says Group Health Physicians cardiologist Tina Ghia, MD, who practices at the Group Health Capitol Hill Campus. For instance, nausea and vomiting, neck pain or tingling, and arm pain can all be indicators. This differs from the chest pain symptoms typically described by men.

Group Health member Crescencia Robina knows this firsthand. She was walking home from the grocery store when she began feeling weak and dizzy. Robina had other health issues, including high blood pressure, so her family rushed her to the emergency room. When a stress test showed only a minor abnormality, a CT scan was ordered and revealed several severe blockages of her coronary arteries. "They told me I needed a heart bypass or else I might have a heart attack," says Robina.

Common Myths About Women and Heart Disease

The idea that a serious heart problem always starts with chest pain is one of several myths about the disease that women and their loved ones should know about.

Myth: Heart disease happens mostly in men.

Truth: Women get heart disease — and die from it — as often as men. Heart disease is the leading cause of death in women over the age of 65, more so than breast or colon cancer, or respiratory diseases.

Myth: Heart disease happens only to those who are middle aged or older.

Truth: "Even if you don't show symptoms until that age, risk factors that can lead to heart disease often begin much earlier," says Dr. Ghia. Diet is a big factor. "All the processed food you eat as a child and in college takes a toll," she says.

By age 18, a person may begin laying down cholesterol deposits in blood vessels, which over time can lead to development and progression of coronary artery disease.

Myth: Taking hormones during and after menopause is probably good for your heart.

Truth: While it's true that women's natural hormones prior to menopause may help protect them from heart disease, studies show that taking hormone supplements after menopause do not have the same effect. "In fact, we see a slight increase in the risk of developing coronary disease among women on hormone replacement therapy," says Dr. Ghia. "I recommend that women taper off and discontinue these supplements."

Myth: Heart disease runs in my family. There's nothing I can do about it.

Truth: If your father had a heart attack before age 55 or your mother before age 65, it is a risk factor for development of heart disease. Other risk factors include diabetes, hypertension, high cholesterol, and smoking. Diagnosis of, and treatment for, these risk factors play a large role in prevention of coronary artery disease. Routine checkups with your primary care physician can help to diagnose and treat these conditions.

But even a family history does not make the disease inevitable. Prevention tips include exercising regularly — ideally at least 30 minutes, 5 days a week — and eating a healthy diet high in whole grains, fruits, and vegetables.

Robina, who is recovering from her bypass, is taking no chances. "My family is very strict with me — no salt, less fat. Whatever is bad for the heart, I can't have," she says, laughing a little. "But I am glad to be here."


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