Myths about coronary heart disease in women

Part 1

When she was approached by a doctor, Nancy Lavin was lying on a hospital bed and thought about the grocery list, which was going to do in the supermarket.

- You have a myocardial infarction - the doctor said.

His words sounded like a thunderclap.

- I was just a shock - recalls Nancy. At that time she was 48 years old.

Like many women, Nancy Lavin did not even suspect that the women is a myocardial infarction. When the first symptoms (nausea and pain in the back), she thought it was food poisoning or the flu, so they seemed harmless.

Today, Nancy Lavin headed by a social movement "Women's heart", bringing together 8 million American women suffering from coronary heart disease (CHD).

"My ignorance and carelessness of doctors almost cost me my life, - says Lavigne. - I do not check the level of cholesterol in the blood for 10 years. When a heart attack, cholesterol level was very high. "

Inexorable evidence suggests that coronary insufficiency - a form of ischemic heart disease - is the main cause of death among American women and kills half a million lives a year.

This problem has attracted more attention. Not by chance one of the most recent annual scientific sessions of the American Society of cellular cardiology was devoted to problems of heart disease in women, and the American National Institute of heart disease, blood and lungs developed the program "The Truth of the heart" to raise awareness about heart disease among women and the promotion of measures that would help women to control their health.

Silent killer

"Women are surprised - said Noel Beira, medical director of Cardiovascular Prevention and Rehabilitation Center (Los Angeles). - They ask: "How could this happen to me?". But realizing what had happened, the women are strong advocates and talk about what they learned to other women. "

Misconceptions are fairly common among the population. The main problem is that women simply do not realize that the danger exists. Cardiovascular diseases are considered to be solely the prerogative of men.

Most women are afraid that they will die from breast cancer, whereas in fact, cardiovascular disease kills one in two women, while breast cancer - only one of 25.

As shown by results of a survey conducted by the American Heart Association, only 8% of women know that cardiovascular diseases constitute the greatest threat to women's health and only 18% of them found out about this danger from their doctors. And among women aged 25 to 35 years of this risk-informed, only 4%.

"On the dissemination of information about breast cancer spent bulk of funds", - says Jennifer Mires, Director of Cellular Cardiology at University Hospital in New York, a renowned expert on heart disease in women.

It's not just that large corporations like Avon fund research for breast cancer, notes Mires. The problem also in the fact that many female celebrities mentioned in their statements about breast cancer. but no one talks about their illnesses associated with the heart. Meanwhile, many male celebrities, for example, guests famous TV presenter David Letterman and Larry King, talking about these diseases. Whatever it was funding research of coronary heart disease in women is not enough.

"People are oriented to the views of celebrities", - said Dr. Mires.

Menopause

The risk of cardiovascular disease in women increases during menopause. Experts believe that this is associated with reduced estrogen levels, which help the work of the heart. For postmenopausal women likely to die from coronary heart disease is 10 times higher than the risk of dying from breast cancer. Women in menopause may mistakenly take the initial symptoms of heart disease, such as fatigue and insomnia, for the symptoms of menopause.

Another problem is the lack of early diagnosis. The average diagnosis of coronary heart disease for women is put at 10 - 15 years later than men. Mainly because most women do not pay enough attention to their health.

"In the family of a woman is often a family doctor for children and a husband and therefore did not pay much attention to himself - says Dr. Mires. - Therefore, we should teach women to take care of their own health. "

Part 2

Jackie Praiano dying within 10 days. No one could understand from what. Electrocardiogram did not show. Before my illness, she was a comely woman of 49 years.

In the end, it became clear that this is a heart attack. When the diagnosis was finally delivered, 10 percent of the heart muscle has been damaged.

"I thought I was going to die, - says Jackie. - How could this happen to me? Nobody ever told me that I should worry about his heart. "

The first physician to whom she addressed, diagnosed a viral infection, and appointed bed rest. Once started in great pain in my heart, and the ambulance took her to the hospital, another doctor diagnosed it as herpes zoster.

This incident occurred 10 years ago.

Jackie is not the only woman, has received such a terrible lesson. Mortality from coronary heart disease among women is increasing in geometric proportions, and often it is because the women themselves, their families and doctors may not recognize the symptoms of the disease.

Every year, 500 thousand women die of cardiovascular diseases such as myocardial infarction and stroke. And women die at 50 thousand more than men.

Women continue dying

Studies show that American scientists, women were taken to hospital with a heart attack, dying at 20% more often than men. In addition, the probability that the time will be held thrombolytic therapy, coronary angiography, angioplasty or coronary artery bypass surgery in women below.

"Doctors learn to diagnose heart disease in men - said Nancy Lavin, the head of a public movement" Women's Heart Foundation, established In 1990-ies. - They are not trained to diagnose heart attacks in women. Lavin also in the past suffered a myocardial infarction.

Symptoms

Symptoms of a heart attack in women are described in comparison with the symptoms of the disease in men. Men often the first symptom is severe pain. In women, symptoms may be atypical, rather atypical for men but not for women. In women, heart attack can give of himself to know the following features:

* A strong discomfort in the lower part of the chest, stomach, jaw, arm or shoulder.
* Nausea, dizziness, shortness of breath.
* Shortness of breath without chest pain.
* Unexplained anxiety, weakness or fatigue without chest pain.
* Trembling, cold sweat, pallor, without chest pain.

63% of women who died from sudden coronary failure - their arteries were clogged with deposits of lipids and cholesterol - had no warning symptoms. Therefore, early detection of disease, monitoring of risk factors (smoking, nutrition), as well as regular analysis of blood cholesterol are the most effective ways to reduce mortality from myocardial infarction and stroke in women.

But often it was not being pursued.

Lavin is wrong exceptional attention to the mammogram and strokes - an approach she calls "bikini medicine.

"Most women are too often visited by gynecologists and consult with them as with general practitioners, - she said. - So when they get to the specialists, but it happens after 45 years, symptoms of heart disease they are more pronounced than in men.

After a heart attack

"Because the diagnosis of coronary heart disease for women is put later than men, respectively, the prognosis for women is considerably worse," - says Jennifer Mires, Director of Cellular Cardiology at University Hospital in New York, a renowned expert on heart disease in women.

According to statistics from the U.S. Agency for Research on quality of care, within one year after myocardial infarction die, at least 40% of women and only 24% of men.

It turns out that women receive less intensive treatment. A recent study by the American Heart Association, found that every year die from a heart attack more women than men, while women produce only 42% of all cardiovascular operations, 29% of coronary bypass surgery and 39% of angioplasty. The probability of death from heart attack or lack of surgical care is higher for women than for men. In addition, women often do not receive adequate assistance or medicines in the postinfarction period.

Different requirements

"In addition to ignorance, it is important and that women's EKG results of tests with the load depended on the hormonal status of the patient and the intensity of the load", - said Dr. Mires. Often the ECG does not reveal the characteristic signs of myocardial infarction. This may be due to different physiological and hormonal factors, or less sensitivity to the test. The most informative tests were echocardiography with stress or pharmacological stress test.

The study of heart disease has historically been based on the treatment of this disease in men. For example, a recent clinical study of artificial heart transplants included only male patients. It is essential that these studies also covered and women, convinced Dr. Mires. Physiology of the female body differs from the physiology of men and, perhaps, the size of the body and the heart play a role in the course of heart disease.

In the U.S. study of heart disease has been pursuing for decades, but women were not included in them until 1990, when the U.S. Congress issued a resolution directing the National Institute of Medicine to include women in the sample studied.

However, women currently represent only 25% of study participants due to circumstances related to pregnancy, family problems, work, and, most importantly, a lack of understanding of what coronary heart disease is not only a disease of men.

What follows?

"We can not sit idly by and wait until the doctors pereuchatsya - says Nancy Lavin of the organization" Women's heart. - Women should know what they should worry about and how to maintain their health."
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