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What is important today is for each woman to learn about and know her coronary risk and then does all she can to minimize those risks. The risk factors include; excess weight – 20 lbs. or more, postmenopausal, family history of heart attack or stroke, high blood pressure, high cholesterol, smoking, excessive alcohol use, diabetes, inactive lifestyle and stress. Education of the medical community on the severity of cardiovascular disease in women is very important. Physicians should all feel comfortable in identifying which women are at increased cardiovascular risk. Once recognized, we need to help them through preventative programs to modify these risks. The first thing that women should do is learn how to determine their risk for future heart attacks. They can assess their risks listed above or may use a tool to assist them in making this determination. It is recommended that women over 35 years of age should have a comprehensive heart screening and evaluation to determine their personal risk for cardiovascular disease. We have found the Framingham Coronary Risk Score; a standard tool developed at John’s Hopkins University Hospital, Maryland, to be useful in making this determination. There is a Framingham Risk Score tool published specifically for men and one for women. If the results score within an intermediate to high risk score the information should be shared with their physician or see a Cardiologist. It might be necessary for one to be referred for a diagnostic workup to evaluate whether or not there is the presence of coronary artery disease. Some of the testing that may be prescribed would be a regular stress test or imaging stress test, coronary calcium score, or CT angiography. Women also present with different symptoms than men. Men usually have, what we believe to be, the classical symptoms of chest pain, shortness of breath, and sweating. Over one third of women will have atypical symptoms such as neck or jaw pain, pain in the arm or hand, shortness of breath or pain in the upper abdomen, chest discomfort usually in the center of the chest and lasting a few minutes of time. Other warning signs are cold sweats, nausea, and lightheadedness. Fatigue is also another typical symptom for women but is one that is difficult to pinpoint as being heart-related. In addition, women have different hearts than men. For example, the coronary arteries of women are usually smaller than men. Since women’ symptoms are atypical, they get to the hospital either too late or not at all and may loose the opportunity to receive the latest treatments. The problem with waiting to get help is that any delay in medical treatment increases the chance of losing heart muscle. The tragic result is that women are twice as likely as men to die within the first weeks following a heart attack. Women also have different issues than men after recovering from a heart attack. Who will manage the household? Who will care for the aging parents and young children and widows are concerned with how they will pay their medical and medication bills. These very issues may be keeping women from seeking the help they really need. Dr. Lebenthal shares with his patients the following Women and Heart Facts; Even is a women is properly diagnosed, she is often not properly tended to, 23% of men dies within on year of their first attack – the number increases to 38% for women, 18% of male heart attack survivors experience a second heart attack within six years compared to 35% of women heart attack sufferers almost twice the percentage. Women are almost two times as likely as men to die after bypass surgery and half as likely to get an angioplasty to open a narrowed blood vessel. The answer is prevention, says Dr. Lebenthal, “know your risk and get the help you need to minimize them, know the signs and symptoms of a heart attack and make sure your physician is listening to you”.
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