Diagnosing heart disease in women can be a challenge. Women often don't realise that their symptoms are caused by a heart problem. Also, the tests to determine if their symptoms are from coronary heart disease are not as reliable as they are for men. Women develop symptoms of heart disease an average of 10 years later than men.
Typical symptoms are:
-- Classic crushing chest pressure below the breastbone with pain and tingling down the left arm, accompanied by profuse sweating, shortness of breath, and light-headedness. Men are more likely to describe symptoms similar to these. Women with coronary heart disease tend to have what doctors refer to as "atypical" symptoms.
They might experience:
-- New episodes of fatigue
-- Shortness of breath
-- Insomnia
-- Indigestion
-- An anxious feeling
Heart disease risk factors for women:
Although the traditional risk factors for coronary artery disease - such as high cholesterol, high blood pressure and obesity - affect women and men, other factors may play a bigger role in the development of heart disease in women. For example:
-- Metabolic syndrome - a combination of fat around your abdomen, high blood pressure, high blood sugar and high triglycerides - has a greater impact on women than on men.
-- Mental stress and depression affect women's hearts more than men's. Depression makes it difficult to maintain a healthy lifestyle and follow recommended treatment, so talk to your doctor if you're having symptoms of depression.
-- Smoking is a greater risk factor for heart disease in women than in men.
-- Low levels of estrogen after menopause pose a significant risk factor for developing cardiovascular disease in the smaller blood vessels (small vessel heart disease).
According to the American Heart Association, there are multiple possibilities for the differences in heart care between men and women:
-- Most of the original cardiovascular research studies were conducted on men. The design of newer studies should yield results that provide more information about women.
-- Women tend to have heart attacks later in life than men, and they often have other diseases (such as arthritis) that might mimic heart attack symptoms.
-- Increased age and the more advanced stages of coronary heart disease in women can affect treatment options available to physicians.
-- Traditional diagnostic tests may not be as accurate in women. The standard exercise stress test (walking on a treadmill with ECG monitoring) does not have the same predictive value in women a it does for men.
What can women do to reduce their risk of heart disease?
There are several lifestyle changes you can make to reduce your risk of heart disease:
-- Exercise 30 to 60 minutes a day on most days of the week.
-- Maintain a healthy weight.
-- Quit or don't start smoking.
-- Eat a diet that's low in saturated fat, cholesterol and salt.
First report of a large population-based study of gender differences in the prevalence and determinants of CAD in adults from an urban setting in the Indo-Pakistan subcontinent using doctors' reports and electrocardiographic criteria. The prevalence of CAD, whichever definition was used, and especially the non-Q wave major ECG changes, was remarkably higher in this urban population than in populations of European origin,13 and rural populations in the Indo-Pakistan subcontinent. The greater prevalence of CAD in the Indo-Pakistan population is likely to be due to a greater susceptibility to the metabolic syndrome; around a third to a half of these middle-aged men and women, respectively, were classified as positive for the metabolic syndrome using current criteria. The greater prevalence of definite CAD in men is largely due to the effect of smoking exposure, which owing to its substantially higher prevalence in men, overwhelms the impact of the greater prevalence of the metabolic syndrome in women.
What do I do if I have angina?
If you have angina that lasts more than 5 minutes - and you DO NOT have a prescription for nitro-glycerine - call for emergency help. DO NOT DELAY. Call for emergency help (dial 911 in most areas). Quick treatment of a heart attack is very important to lessen the amount of damage to your heart. Due to the possible benefits of taking aspirin early on during a heart attack, emergency personnel may tell you to chew an aspirin if there is no medical reason for you to avoid aspirin. If your symptoms stop completely in five minutes, still call your doctor to report your symptoms.
If angina occurs and you have been prescribed nitro-glycerine (a medication):
-- Stop what you are doing and rest.
-- Take one nitro-glycerine tablet and let it dissolve under your tongue, or if using the spray form, spray it under your tongue. Wait 5 minutes.
-- If you still have angina after 5 minutes, call for emergency help (dial 911 in most areas) or have someone take you to the local emergency room. Emergency personnel may tell you to chew an aspirin to break up a possible blood clot, if there is not a medical reason for you not to take aspirin.
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