Heart disease is the No. 1 killer of women, but many don't recognize the warning signs. They may ignore the symptoms or mistake them for more benign ailments. Dr. Shannon J. Winakur, medical director of the Women's Heart Center at Saint Agnes Hospital, said women should be more aware of heart disease and how to prevent it.
How are the warning signs of heart disease different in women?
Warning signs of heart disease typically occur with exertion and go away with rest. The classic symptom of heart disease is a dull tightness in the center of the chest, which may or may not radiate to the neck, jaw, left shoulder or left arm. Women can certainly have these symptoms, but they also often describe sharp or burning chest pain. Women with heart disease also commonly experience shortness of breath and fatigue. Other warning signs include nausea, palpitations or breaking out in a cold sweat.
Because many of the symptoms that women experience are not localized to the chest, they often dismiss them as not significant, and they delay getting the care they need. This is why it is so important for women to keep their hearts in mind when they are not feeling well, for any reason.
Are women susceptible to certain heart conditions over men and if so why?
More women than men are diagnosed with, and die from, cardiovascular disease each year. After a heart attack, women are more likely than men to die, to have another heart attack, to have heart failure and to have a stroke.
What are the preventive measures specific to women?
Studies have shown that preventive measures can have a positive impact on up to 90 percent of a woman's cardiovascular risk. There are several risk factors that are more predictive of heart disease in women: smoking, diabetes and a low HDL, or good cholesterol, level.
Half of all coronary events in women occur in smokers. Women who smoke have six times the risk of having a heart attack as women who have never smoked (in contrast to a threefold increased risk in male smokers). Quitting smoking would have a big impact on reducing the number of cardiovascular events in women.
Diabetes also appears to increase a woman's risk of having a heart attack more than a man's. It is important for women to prevent the onset of diabetes by maintaining a healthy weight and exercising regularly.
Our best treatment for a low HDL is exercise — it is more effective than many medications. This is another reason for women to make a commitment to exercising at least 30 minutes most days of the week.
What are the first three things women should do when they think they are having a heart attack?
Call 911, call 911, call 911! I have heard so many stories of women who were having symptoms but didn't want to bother or worry anyone. They are lucky to be alive and able to tell those stories today.
What should a woman do if she feels her doctor is not taking her symptoms seriously?
I would recommend that women ask their doctors specifically about the need for testing to check for heart disease, or ask for a referral to a cardiologist. Women can also call directly for an appointment with a cardiologist, unless their insurance requires a referral from their primary care doctor. If symptoms persist or worsen, they could always go to their nearest emergency department.
When should women start getting heart screenings and why?
I believe it is never too early for a woman to have a heart screening, to know about her cardiac risk factors and what she can do to decrease her risk. I encourage women starting at 18 to get a heart screening, if for no other reason than to get a baseline snapshot of their heart health. There are so many regular screenings that have become commonplace for women, such as Pap smears and mammograms. With heart disease being the No. 1 killer of women in the United States, it's crucial that heart screenings get added to that list.
What does a heart screening entail?
The Women's Heart Center at Saint Agnes has created a "60 Minute Heart Check," where women answer a questionnaire about risk factors. They also have blood pressure, weight, and waist circumference measured and get an EKG. Blood work is also done, including a fasting cholesterol profile and a hemoglobin A1c, which is a measure of blood sugar. They then receive a personalized risk assessment, with steps recommended to decrease their risk of coronary artery disease.
A referral to a cardiologist is made based on the woman's risk factors and symptoms, and further diagnostic testing can follow if needed.