Heart disease: decades in the making

by Carolyn Thomas      @HeartSisters  

I was surprised to learn after surviving my own heart attack that cardiac events like mine may take 20-30 years to actually show up. In other words, I didn’t have a heart attack because I ate a piece of bacon or had a stressful day at work. I had a heart attack because something – likely decades earlier – had damaged the delicate endothelial cells lining my coronary arteries.          .      .  .    .   Continue reading “Heart disease: decades in the making”

Cardiac research and the mystery of the missing facts

by Carolyn Thomas    @HeartSisters

Over the years, I’ve had to teach myself the bare bone basics of interpreting cardiac studies. I’m certainly no research scientist (although I did spend 20 years of my life with one – does that count at all?) but I can tell you that one good place I like to start is the methodology section of any study.

Wait!  Don’t leave yet!   I know, I know, this may seem crushingly dull. But the methods info is how I learned, for example, that out of over 5,000 participants recruited for the $100 million ISCHEMIA study in 2019, only 23 per cent were women. At the time, I offered a helpful editing suggestion to the Washington Post about their sensational coverage of ISCHEMIA (“Stents and Bypass Surgery are No More Effective Than Drugs!!” ) by requesting this important clarifier added to the end of that headline: FOR MEN!”       .        .     Continue reading “Cardiac research and the mystery of the missing facts”

When cancer treatment damages your heart

by Carolyn Thomas     @HeartSisters

It seems a cruel irony: the very thing that may have saved your life after a frightening cancer diagnosis is the same thing that can ultimately endanger your heart. I first heard of the known link between cancer treatments and later heart disease when I was a text editor of the palliative care textbook called Medical Care of the Dying.1  I learned about patients with end-stage heart disease caused by their cancer treatments, sometimes decades earlier.  .   .
Continue reading “When cancer treatment damages your heart”

MDs often tell women to lose weight rather than address cardiac risk factors

by Carolyn Thomas     @HeartSisters    March 31, 2019

This editorial, What Women (and Clinicians) Don’t Know Hurts Them, originally appeared in the Journal of the American College of Cardiology. As a woman with heart disease, I wanted to immediately read it to find out what might be hurting me.

But as is common practice in most medical journals, this editorial was behind a paywall, so it was not available for heart patients like me, or anybody else who wasn’t a subscriber to the journal.

I could pay a fee of $35 for the privilege of reading this one article, but the reality is that I can’t afford to pay for articles that aren’t being published in what’s known as an open access journal.* Continue reading “MDs often tell women to lose weight rather than address cardiac risk factors”

Dear Carolyn: “People can change for the better”

by Carolyn Thomas    @HeartSisters    October 28, 2018

We know now that childhood trauma is strongly associated with chronic illness later on, including heart disease. As I wrote in a recent blog post about ACE (Adverse Childhood Experiences), researchers warn us that scoring 4 or higher on the ACE test can predict a significantly higher risk of physical or mental illness as an adult. I was stunned when I took the test and saw that my own score was 4; I was well aware of my childhood experiences, of course, but I thought that only marginalized kids from desperately poor families were at high risk – and that wasn’t me! A history of psychological childhood abuse or neglect is not what we expect our doctors to ask us about – but this research suggests that maybe they should start.

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One response to that post really hit home for me. Marie (who prefers not to use her real name here) lives with a type of ischemic heart disease called coronary microvascular disease (as I do, too). With her kind permission, I’m sharing her childhood story with you as the latest guest post in my regular but very occasional series called Dear Carolyn“:

Oh, great. Another cardiac risk factor to worry about…

by Carolyn Thomas    @HeartSisters    October 7, 2018

There are lots of cardiac risk factors that increase our chances of developing heart disease one day. Some are beyond our control (like having a family history) and many are not (like smoking or a sedentary lifestyle).

Some other risk factors are less familiar, so are often overlooked. Until two years after my heart attack, for example, I didn’t know that having pregnancy complications (like the preeclampsia I was diagnosed with while pregnant with my first baby) can mean women are 2-3 times more likely to be diagnosed with heart disease years later. But here’s a cardiac risk factor that was new to me until I learned about something called the ACE study. And this is a big one. Continue reading “Oh, great. Another cardiac risk factor to worry about…”