Premenopausal women and cardiac symptoms

by Carolyn Thomas      @HeartSisters

Most of you throughout your adolescent and adult lives have no doubt observed that hormone fluctuations during a menstrual cycle can affect certain body parts on certain days of that cycle. These fluctuations cause symptoms ranging from bloating to cramps, vivid dreams, fatigue, acne breakouts, food cravings, or irritability. (That word ‘irritability’ is doctor-speak to describe the act of threatening spouses with homicide if they leave that freakin’ toilet seat up one more time…)

For decades, scientists have also observed that women’s risk of heart attack increases after menopause. One theory for this age-related delay (compared to male heart patients, who generally tend to have their heart attacks a decade or so before we do) was the drop in female hormones at menopause, particularly estrogen. That timing seemed to intuitively make sense. Estrogen levels go down, heart attack rates go up. It’s why physicians believed for a long time that hormone replacement therapy in postmenopausal women could actually prevent heart attacks. (PLEASE NOTE: it doesn’t.*) Continue reading “Premenopausal women and cardiac symptoms”

Heart attacks: “Men explode, but women erode”

by Carolyn Thomas  ♥ @HeartSisters

heart-460546_1280Los Angeles cardiologist Dr. Noel Bairey Merz believes that the biggest issue facing women heart patients is that as a society we have been programmed to think of heart disease as a man’s problem. During a presentation in Australia last year, she told her audience:

“The fatty build-up of plaque in a coronary artery causing a heart attack will usually rupture or ‘explode’ in men.

“But in women, it will often be a much smaller, more subtle event, caused by ‘erosion’, not explosion. 

“Often their symptoms may throw doctors off track to the wrong diagnosis, and in many cases, women won’t even know they have had a heart attack until it’s too late.”   .

Continue reading “Heart attacks: “Men explode, but women erode””

What’s the single biggest health threat women face?

One out of every two of you reading this right now will be impacted by cardiovascular disease in your lifetime, warns cardiologist Dr. Noel Bairey-Merz, Director of the Cedars Sinai Women’s Heart Center in Los Angeles. And worse, diagnostic and treatment strategies “developed in men, by men, for men for the last 50 years” are not working so well for women.

Go grab a cup of coffee, sit back, and enjoy this must-see presentation.

Why your heart needs work – not rest! – after a heart attack

by Carolyn Thomas  @HeartSisters

After surviving a heart attack, I couldn’t wait to start my 4-month cardiac rehabilitation program so I would just start feeling “normal” again. But when I showed up for my first assessment, I was disappointed by the cardiac nurse’s recommendation that, because of ongoing issues, I should wait two months until I felt much stronger before starting. A Canadian study from the University of Alberta now suggests, however, that earlier might just be better for many.

For best results in most clinically stable patients after a heart attack, these new findings suggest that early exercise as well as prolonged exercise may well be the key to the best post-heart attack outcomes.  Continue reading “Why your heart needs work – not rest! – after a heart attack”

His and hers heart disease

heart man womanby Carolyn Thomas  @HeartSisters

Should we invent a new name for women’s heart disease? A review on the topic of gender differences in heart disease reminds us what many heart attack survivors already know: when it comes to heart attacks, women are not just small men.

Standard cardiac treatment typically focuses on obstructive coronary artery disease, which up to half of women may not ever experience. In obstructive coronary artery disease, the large blood vessels in the heart can become blocked through atherosclerosis, a condition in which fatty cholesterol streaks build up in the arteries.

In fact, the Framingham Risk Score, based on a study of over 5,000 participants (and their descendents) followed since 1948, is the traditional measure of heart disease risk, yet this scale mistakenly classified almost 90% of women as low risk – which is hard to get your brain wrapped around given that more women than men die each year from heart disease.

But in small vessel disease, the narrowing of the very small arteries in the heart means they can’t expand properly. As a result, your heart muscles don’t get an adequate supply of oxygen-rich blood. This inability to expand is called endothelial dysfunction. This problem may cause your small vessels to become even smaller when you’re active or under emotional stress. The reduced blood flow through the small blood vessels causes chest pain and other debilitating symptoms similar to those you’d have if you were having a heart attack. Continue reading “His and hers heart disease”