Why Heart Disease is different in Women
Irina Staicu, MD, RPVI
ABVLM Diplomat
Nuclear Cardiology Diplomat
The community has viewed women health
almost with a “bikini” approach, looking
essentially at breast and reproductive system,
ignoring the rest of the women
as part of the women’s health “
Nannette Wagner, MD
Professor of Medicine Emory University
- Screening guidelines for cancers allows early recognition ,improving detection , treatment and cure.
- Women education about mammograms and pap smears led to improved survival
- No definite screening guidelines exist for Heart Disease
Breast cancer vs. Heart Disease
•For every women that dies from breast cancer there are six that die from heart disease
•Younger women are twice as likely to die from a heart attack than younger men
•There is higher mortality risk in younger vs. older women
Over 8,000,000 American
women
live with heart disease
Leading causes of death for American women
Why heart disease in women is different
•Smaller heart arteries
•Aspirin to prevent heart attack may have different benefits in women than men
•Atypical symptoms are hard to be recognized
•Breast cancer therapy increases the risk of heart attack
•Different response to known treatments
•Women are more likely to delay treatment in emergency care
•Metabolic syndrome is more common in women
•Heart tests lead to more false results in women than men
Atypical symptoms in women
- 71% of women experience early warning signs of heart attack with atypical symptoms, sometimes flu-like symptoms, nausea, epigastric pain, and no Chest Pain
- Nearly two-thirds of deaths from heart attacks in women occur among those who have no history of chest pain.
•Between the ages of 45 and 64, one in nine women has some form of heart disease
• Above the age of 65 one in three women has some form of heart disease
•Heart disease may not be recognized and symptoms may be “blamed on aging”
Risk factors for Heart Disease
Common for men and women
•Men > 45, Women > 55 yrs
•Hypertension > 140/90
•Diabetes
•High Cholesterol
“bad” LDL > 160
“good” HDL < 40 in men,
< 50 women
•High Triglycerides > 150
•Family history of heart disease
•Smoking
•OSA
•Metabolic syndrome
•“ CAD equivalent”
Carotid stenosis
Peripheral arterial disease
Abdominal aortic aneurysm
•Anemia
•Early menopause
•Chronic Inflamatory states
Polycystic ovary
Rheumatoid arthritis
Lupus
•Kidney disease
•Thyroid disease
•Low bone density
•Cancer and history of radiation or chemotherapy
• Psychosocial factors
Specific Risk factors for Heart Disease in Women
Cardio-Oncology
How cancer affects heart
- Chemotherapy and radiation therapy increases the risk of HD.
- The risk remains high years after cancer resolution.
- Cardiac monitoring decreases the risk of Heart disease and complications of cancer treatment
Today cancer patient may become tomorrow heart patient, without early recognition and treatment
Testing for heart disease
More false results in women than men
•Angiogram
•Echocardiogram
•Stress test – high false positive rates with regular exercise in women; BEST is with an imaging agent – nuclear test
•Carotid ultrasound
•Leg ultrasound
( peripheral vascular ultrasound)
•CT Angiography with calcium scoring
Where do we go from here?
Acknowledge
- High incidence of Heart Disease Nr 1 Killer in women
- Atypical symptoms
- Challenges in diagnosis
- Worse outcome in women than men
Recognize
- Unique Risk factors in women
- The importance of HD prevention
Be knowledgeable and your own advocate
Why Heart Disease is different in Women
By Irina Staicu
