Tag Archives: non-obstructive heart disease

Do women need different treatment of coronary artery disease?

19 Nov

by Carolyn Thomas    @HeartSisters

Dr. William Bestermann, in reviewing his own 40+ year career as a physician, now concludes that, in all of medicine, “there is no better example of the disconnect between what we know and what we do than in the case of women with coronary artery disease.” I’m a woman who has survived a widowmaker heart attack, and now lives with coronary microvascular disease, and I’ve only been writing about such sentiment for eight years. As Dr. B. explains bluntly:

“Every other week, I see a woman who has had symptoms of coronary artery disease and has been told that the problem is her esophagus – or worse – depression or anxiety.  She is told in effect: ‘Go home, take your anti-anxiety drugs, you will be fine!’  What she has been told is often wrong – too often, dead wrong!” Continue reading

Coronary Microvascular Disease: a “trash basket diagnosis”?

20 Mar

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by Carolyn Thomas  @HeartSisters

Dr. Juan Carlos Kaski, Head of the Cardiovascular Sciences Research Centre, St. George’s University of London in the U.K. explains an unusual cardiac diagnosis here that I happen to share: Inoperable Coronary Microvascular Disease (MVD).

When I was at Mayo Clinic five months after my heart attack, cardiologists there referred to MVD as a “trash basket diagnosis” – not because the condition doesn’t exist, but because this disorder of the tiniest blood vessels in the heart is so often missed entirely. A correct diagnosis usually happens only after all other possible diagnoses are thrown out. It’s far more common in women and in people who have diabetes. It’s treatable, but can be very difficult to detect. Continue reading

How a woman’s heart is different from a man’s

14 Nov

by Carolyn Thomas     @HeartSisters

In many ways, the fact that my cardiac treadmill stress test results appeared “normal” was not a surprise, despite my textbook heart attack symptoms of crushing chest pain, nausea, sweating and pain radiating down my left arm. What we now know is that single-vessel heart disease, which is more common in women than in men, may be less likely to be picked up at all on a treadmill test.

Even though my left anterior descending coronary artery was 95% blocked, this didn’t show up. Similarly, for other women non-obstructive heart disease (again, more common in women) is harder to identify given our existing diagnostics. Women are more likely to suffer from coronary microvascular disease affecting the smallest blood vessels of the heart. And spasm conditions like Prinzmetal’s variant angina are difficult to catch at the best of times, but women can be just as dead after a heart attack caused by undiagnosed Prinzmetal’s as they would be due to fully-occluded coronary arteries.   Continue reading

How women can have heart attacks without having any blocked arteries

25 Apr

by Carolyn Thomas  ♥  @HeartSisters

Turns out that the kind of heart attack that I had (caused by a 95% blockage in the big left anterior descending coronary artery) – the so-called widowmaker heart attackmay actually be relatively uncommon  in women. You might guess that fact by its nickname.  It’s not, after all, called the “widower-maker”.

While cardiologists warn that heart disease can’t be divided into male and female forms, there are some surprising differences. Cardiologist Dr. Amir Lerman at the world famous Mayo Clinic in Rochester, Minnesota, told the Los Angeles Times recently:

“When it comes to acute heart attacks and sudden death from cardiac arrest, women have these kinds of events much more often without any obstructions in their coronary arteries.”

Instead, it appears that a significant portion of women suffer from another form of heart disease altogether. It affects not the superhighway coronary arteries but rather the smaller arteries, called microvessels. These tiny arteries deliver blood directly to the heart muscle.

Ironically, I can now boast two diagnoses for the price of one – first, the widowmaker heart attack caused by a fully occluded coronary artery back in 2008, and then, after several months of puzzling, ongoing cardiac symptoms – like chest pain, shortness of breath, and crushing fatigue – a second diagnosis of inoperable coronary microvascular disease. Continue reading