Dr. Goldberg shares what medical professionals have learned in the last five years about women and heart attacks.
We’ve learned lots in the last five years about women and their heart attacks. For instance, believe it or not, women who are under 50 who have their first heart attacks, they’re twice as likely to die of their first heart attack compared to men. And, when there had been anatomic studies, autopsy studies, one that looked at the arteries of young men and women like in their late teens and early 20s who had died in car accidents, and we found out the earliest build-up of plaque, the building block of a heart attack is cholesterol, the gunky stuff that builds up in the walls of your artery, start when we’re pretty young, and it really does relate to smoking and a high-fat diet and obesity.
So we have that information, all the more reason to think about, as early as you can, prevention. So as a women’s health project, we know that heart disease is not only about preventing a heart attack in that woman, but also in her family, and since the women take care of their families, it’s the perfect place to start.
The other thing we’ve learned that the gold standard test, the coronary angiogram that I mentioned that my patient had before, she was lucky. She had an obvious blocked artery. In some women they have symptoms and have pressure in their chest on exertion or shortness of breath on exertion that goes away with rest, and those are symptoms we call angina, chest pressure due to a blocked artery.
Well, sometimes these women have these symptoms and even have abnormal stress tests, but when they go for coronary angiography, the study where the doctor puts a small catheter up the artery in your groin to the heart and then injects x-ray dyes so that we can opacify the arteries, that you don’t see a clear-cut blocked artery.
The women have symptoms but they don’t have a blocked artery that could be opened up with a balloon, a stent placed, or even bypass to be done on. So does that mean they don’t have heart disease? No, they do have heart disease, but sometimes their plaque is so evenly distributed in the arteries that you don’t see this crimping of the artery that’s more common either in men, or in women after menopause.
So we don’t see this even build-up of plaque, and so it doesn’t look like it’s blocked. So the women were being told they don’t have any problems, yet in 30% of those women have heart attacks, 30% of those cases women have heart attacks.
So we have to be more vigilant about connecting the symptoms women have and the behavior of the symptoms.
About Dr. Nieca Goldberg, M.D.:
Dr. Nieca Goldberg is a cardiologist and a nationally recognized pioneer in women’s heart health. Her New York City practice Total Heart Care focuses primarily on caring for women. Dr. Goldberg is Clinical Associate Professor of Medicine and Medical Director of NYU Women’s Heart Program, the Co-Medical Director of the 92nd Street Y’s Cardiac Rehabilitation Center, a national spokesperson for the American Heart Association’s “Go Red” campaign – an association for which she has volunteered for over 15 years and been a board member in NYC. She was formerly the Chief of Women’s Cardiac Care at Lenox Hill Hospital in New York City.