Why Heart Disease is different in Women

 

Irina Staicu, MD, RPVI

ABVLM Diplomat

Nuclear Cardiology Diplomat

• 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

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?