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Carbondale, PA
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Women and Heart Disease  .

For years, women have been living with a myth  - heart disease is a man’s disease.  The truth is that every 20 seconds; someone in the United States has a heart attack.  Due to tremendous medical advances in the past decade, fewer people are dying from heart attacks.  However, they account for one-third of all deaths in women, and they are the leading cause of death in women over age 50, more than cancer and accidents combined.

“One of the most important things women can do to combat this disease is lipid management”, according to Dr. Lakshmi Mizin, a cardiologist at Marian Community Hospital.  “Several new major studies indicate that low levels of high density cholesterol, the “good cholesterol” is a strong independent indicator predictor of cardiovascular disease in women.  I encourage women to learn about cholesterol, learn their complete levels, not just an overall number.  Even with a total cholesterol level that is normal, women are at higher risk for this disease if their HDL is low or if their low density cholesterol level is very high.”

          “The heart pumps blood through blood vessels to distribute oxygen used by tissues throughout the body,” explains Dr. Mizin.  “The arteries that supply blood to the heart itself are called the coronary arteries.  If these arteries become clogged over time with plaques from arteriosclerosis, this is called coronary artery disease or “heart disease”.  If the arteries become suddenly clogged or blocked from a blood clot that cuts off all or most of the oxygen to a part of the heart muscle, a heart attack may result.”

          The classic symptoms of heart attack are crushing chest pain, which may extend to the shoulder, to the jaw, or down the arm; shortness of breath; sweating; nausea and/or vomiting; dizziness; rapid or irregular pulse; and weakness.  These symptoms are often brought on by physical exertion (a classic example is shoveling snow) or sudden emotional stress.  While this is true in many cases, many heart attacks are “mild” and some are even “silent” with few if any symptoms. 

          Mild or moderate heart attacks may present with more subtle symptoms and many patients, especially women, may have what are considered “atypical” symptoms, such as burning across the upper abdomen or mid-chest.  “Chest pain is the most important symptom of heart disease in women,” relates the cardiologist.  Many women do not get evaluated for their chest pain early enough because they feel that it ‘couldn’t be’ from their heart.  Women often self-medicate for indigestion or attribute their symptoms to stress, anxiety, or minor injuries long before consulting their physician about the true origin of the chest pain. 

          Women also more commonly experience other cardiac symptoms than do men: women may complain of fatigue; difficulty breathing or shortness of breath; back, shoulder, arm or abdominal pain.   These are not generally recognized as potential symptoms of heart disease or heart attack, thus further delaying proper medical evaluation and treatment.

          There are numerous gender differences in heart disease and heart attack.  For men and women with similar risk profiles, medical evidence of heart disease usually occurs about 10 years later in women.  Heart attacks generally occur as much as 20 years later in women than men.  Perhaps because of this age difference, women who have a heart attack are more likely to die than men as a result.  A recent study in the New England Journal of Medicine show there is even greater differences among gender mortality rates than previously believed.  This is especially relevant because most women at risk for heart disease don’t know it, have not discussed it with their doctor and have not been properly or completely evaluated or treated yet women are much more likely to die from a heart attack than men.

          Once women are diagnosed with heart disease, the prognosis does not improve as well as men with similar risks.  Because women usually get their diagnosis later, often when the disease is far more advanced than in men, they do not fair as well with the various medical procedures for heart disease.  These increased risks underscore the greater need for preventive measures in women than in men as well as the increased need for early diagnosis and treatment.

          “All women should be screened for total cholesterol and HDL abnormalities,” stressed Dr. Mizin.  “While heart disease usually strikes women at a later age, watching indicators like cholesterol from an earlier age gives the time to take preventive measures.”

          Dr. Mizin advises women to learn their risk factors, discuss them with their physician and review what they can do to decrease the chances of heart disease.  According to the American Heart Association, half of all heart attacks are linked to known risk factors that can be reduced or eliminated.  The bad news is that most Americans do not control these risk factors.  Of the nine major risk factors, only age and family history can not be modified.

1.      Age for men, age and menopausal/hormone replacement therapy status for women; Family history; Smoking; Elevated Cholesterol; especially LDL and triglycerides; Blood Pressure; Blood sugar; Exercise; Being overweight and stress.


An important list of questions for every women to ask her doctor.

1.      Should I have any specific tests to evaluate my heart?

2.      Are my cholesterol levels ok or should I improve them and how?

3.      Are there specific exercises or activities I should do or avoid?

4.      If you are menopausal or postmenopausal: Should I consider estrogen
   replacement therapy?

5.      If you are perimenopausal: Should I consider low-dose birth control pills?

6.      Are there any medications – prescription or over-the-counter – that might
   effect my risk or heart disease?

7.      Do I need to adjust current medications?

8.      Should I be taking an aspirin a day?

9.      Should I be tested for diabetes?

10.   Should I be taking dietary supplements (calcium, magnesium, potassium and folic acid)?  

11.    Should any members of my family be evaluated for heart disease?

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