Can Symptoms Differ For Women
Although men and women can experience the same symptoms of coronary heart disease, women often experience no symptoms or have different symptoms than men do.
- Activity that brings on chest pain. In men, angina tends to worsen with physical activity and go away with rest. Women are more likely than men to have angina while they are resting. In women who have coronary microvascular disease, angina often happens during routine daily activities, such as shopping or cooking, rather than during exercise. Microvascular angina events may last longer and be more painful than other types of angina.
- Location and type of pain. Pain symptoms are different for each person. Women having angina or a heart attack often describe their chest pain as crushing, or they say it feels like pressure, squeezing, or tightness. Women may have pain in the chest or the neck and throat.
- Mental stress. Mental stress is more likely to trigger angina pain in women than in men.
- Other symptoms. Common signs and symptoms for womenincludenausea, vomiting, shortness of breath, abdominal pain, sleep problems, fatigue, and lack of energy.
Keep Your Diabetes Under Control
If you are diabetic, you have a greater risk of developing coronary heart disease. You can reduce your chances of developing diabetes by being physically active, controlling your weight, and keeping your blood pressure under control. If you have diabetes, these three things will help you to keep control of your blood sugar level. If you are diabetic, your target blood pressure level is below 130/80mmHg.
Screening For Coronary Heart Disease Risk
The guidelines for cardiovascular disease prevention recommend that cardiovascular risk factors be assessed at least annually to identify the presence of coronary heart disease in women with diabetes. They also recommend that people with diabetes be screened for the presence of micro- or macroalbuminuria, or the presence of albumin in the urine. Albuminuria is a sign of nephropathy, or kidney disease. It is also associated with a higher risk of cardiovascular disease.
Your physician may also recommend certain diagnostic tests to assess your heart function. A stress test is used by a physician to assess how well a persons heart handles work. During the test, the person is hooked up to a heart monitor and is asked to walk on a treadmill at varying speeds. The heart monitor generates an electrocardiogram, or a graphic representation of the electrical impulses in the heart. As a person walks, his heart rate, blood pressure, electrocardiogram, and how he feels are monitored.
People with diabetes who experience typical or atypical cardiac symptoms or have had an abnormal resting electrocardiogram may be advised to have a stress test for diagnostic purposes. Additionally, people with diabetes who have a history of peripheral or carotid occlusive disease are older than 35, have a sedentary lifestyle, and plan to begin a vigorous exercise program or have two or more major coronary heart disease risk factors may be advised to have a stress test for screening purposes.
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Keep Blood Sugar Under Control
CAD is the leading cause of death in people with diabetes. The two conditions share many of the same risk factors, including high blood pressure, high LDL cholesterol, and obesity.
Uncontrolled high blood sugar damages arteries. In time, this damage can lead to heart disease. Because of how diabetes affects blood sugar levels, people with it are twice as likely to die from heart disease than people without it.
To lower your risk of CAD, manage high blood pressure, obesity, and high cholesterol with lifestyle changes and medication. Also, work with your doctor to keep your blood sugar levels under good control.
Concept Of Coronary Heart Disease Risk
Patients with angina or a history of MI, or other major atherosclerotic disease, are at high risk of death from CHD. These patients have the highest priority for coronary prevention because the quality of the evidence that their lives can be extended and their morbidity decreased is among the best available for any aspect of medical practice. Such patients identify themselves to medical services and it is not necessary to measure absolute coronary risk before deciding on intervention.
Although patients with CHD are at high absolute risk of a further event compared to the healthy population, some individuals without any clinical manifestation of CHD, such as those with diabetes mellitus, may be at greater risk because of the coexistence of multiple predisposing factors. Thus, the division of prevention into primary or secondary is to an extent arbitrary, in relation to the biology of atherosclerotic disease and its complications. In medicine, however, this distinction reflects the reality of clinical practice because patients with symptomatic disease present to medical services and thus are already receiving care which should include secondary prevention, whereas high risk individuals in the general population have to be sought through screening, whether opportunistic or systematic, in order to deliver primary prevention.
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How To Prevent Coronary Heart Disease
Studies show that heart-healthy livingnever smoking, eating healthy, and being physically activethroughout life can prevent coronary heart disease and its complications.
Work with your doctor to set up a plan that works for you based on your lifestyle, your home and neighborhood environments, and your culture. Working with a team of healthcare providers may help with making changes in your diet, being physically active, managing other medical conditions, and helping you quit smoking.
How Your Heart Changes With Age
People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.
Aging can cause changes in the heart and blood vessels. For example, as you get older, your heart can’t beat as fast during physical activity or times of stress as it did when you were younger. However, the number of heartbeats per minute at rest does not change significantly with normal aging.
Changes that happen with age may increase a person’s risk of heart disease. A major cause of heart disease is the buildup of fatty deposits in the walls of arteries over many years. The good news is there are things you can do to delay, lower, or possibly avoid or reverse your risk.
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Take Charge Of Your Medical Conditions
If you have high cholesterol, high blood pressure, or diabetes, you can take steps to lower your risk for heart disease.
Your health care team should test your blood levels of cholesterol at least once every 4 to 6 years. If you have already been diagnosed with high cholesterol or have a family history of the condition, you may need to have your cholesterol checked more often. Talk with your health care team about this simple blood test. If you have high cholesterol, medicines and lifestyle changes can help reduce your risk for heart disease.
High blood pressure usually has no symptoms, so have it checked on a regular basis. Your health care team should measure your blood pressure at least once every 2 years if you have never had high blood pressure or other risk factors for heart disease.
If you have been diagnosed with high blood pressure, also called hypertension, your health care team will measure your blood pressure more often to make sure you have the condition under control. Talk with your health care team about how often you should check your blood pressure. You can check it at a doctors office, at a pharmacy, or at home.
If you have high blood pressure, your health care team might recommend some changes in your lifestyle, such as lowering the sodium in your diet your doctor may also prescribe medicine to help lower your blood pressure.
What Is A Heart Attack
A heart attack is when part of the heart muscle is damaged or dies because it isnt getting enough blood from the coronary arteries. Heart attacks usually result from a blockage in the coronary arteries. This blockage is most likely caused by a blood clot that forms from tears in the plaque inside the artery.
What Causes Coronary Artery Disease
CAD is caused by plaque buildup in the walls of the arteries that supply blood to the heart and other parts of the body.
Plaque is made up of deposits of cholesterol and other substances in the artery. Plaque buildup causes the inside of the arteries to narrow over time, which can partially or totally block the blood flow. This process is called atherosclerosis.
Signs Of Heart Disease
Early heart disease often doesn’t have symptoms or the symptoms may be barely noticeable. That’s why regular checkups with your doctor are important.
Contact your doctor right away if you feel any chest pain, pressure, or discomfort. However, chest pain is a less common sign of heart disease as it progresses, so be aware of other symptoms. Tell your doctor if you have:
- Pain, numbness, and/or tingling in the shoulders, arms, neck, jaw, or back
- Shortness of breath when active, at rest, or while lying flat
- Chest pain during physical activity that gets better when you rest
- Swelling in the ankles, feet, legs, stomach, and/or neck
- Reduced ability to exercise or be physically active
- Problems doing your normal activities
Problems with arrhythmia are much more common in older adults than younger people. Arrhythmia needs to be treated. See a doctor if you feel a fluttering in your chest or have the feeling that your heart is skipping a beat or beating too hard, especially if you are weaker than usual, dizzy, tired, or get short of breath when active.
If you have any signs of heart disease, your doctor may send you to a cardiologist, a doctor who specializes in the heart.
The Symptoms Of A Heart Attack
The discomfort or pain of a heart attack is similar to that of angina, but it is often more severe. During a heart attack, you may also experience the following symptoms:
The symptoms of a heart attack can be similar to indigestion. For example, they may include a feeling of heaviness in your chest, a stomach ache or heartburn. A heart attack can happen at any time, including while you are resting.
Why Does Coronary Heart Disease Affect Women Differently
Coronary heart disease is different for women than men because of hormonal and anatomical differences.
- Hormonal changes affect a womans risk for coronary heart disease. Before menopause, the hormone estrogen provides women with some protection against coronary artery disease. Estrogen raises levels of HDL cholesterol and helps keep the arteries flexible so they can widen to deliver more oxygen to the tissues of the heart in response to chemical and electrical signals. After menopause, estrogen levels drop, increasing a womans risk for coronary heart disease.
- The size and structure of the heart is different for women and men. A womans heart and blood vessels are smaller, and the muscular walls of womens hearts are thinner.
- Women are more likely to have nonobstructive coronary heart disease or coronary microvascular disease. These types are harder to diagnose than obstructive coronary artery disease, which can be harder to diagnose. This can cause delays in getting diagnosed and treated.
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Southern Cross Medical Library
The purpose of the Southern Cross Medical Library is to provide information of a general nature to help you better understand certain medical conditions. Always seek specific medical advice for treatment appropriate to you. This information is not intended to relate specifically to insurance or healthcare services provided by Southern Cross. For more articles go to the Medical Library index page.
Medical Tests For Heart Disease
Your doctor will check your blood pressure and do a fasting blood test to check your cholesterol, a type of fatty substance that can contribute to plaques in your arteries. He or she might also do a blood test to check the levels of proteins that are markers of inflammation in the body and suggest you have an electrocardiogram . This test looks at electrical activity in your heart. A chest x-ray will show whether your heart is enlarged or your lungs have fluid in them both can be signs of heart failure. The doctor might do a blood test for brain natriuretic peptide , a hormone that increases in heart failure. If the cardiologist needs to determine your heart or valve function, he or she may order an echocardiogram, a painless test which uses sound waves to produce images of your heart in motion.
To learn more about heart disease, visit the National Heart, Lung, and Blood Institute.
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Diagnostic Tests And Procedures
To diagnose coronary heart disease, your doctor may order some of the following tests.
If you have coronary heart disease risk factors, your doctor may recommend diagnostic tests even if you do not have symptoms.
Nonobstructive coronary artery disease and coronary microvascular disease can be missed because patients or doctors may not recognize the warning signs. Diagnosing these types often requires more invasive tests or specialized tests, such as cardiac PET scans, that are not widely available.
G Other Atherosclerotic Disease
Patients with cerebrovascular and peripheral arterial disease should be managed in the same way as those with established CHD. There is virtually no clinical trial evidence to support such a view, but what trial data are available support the treatment of BP, serum cholesterol, and blood glucose as risk factors for atheroma in these other vascular territories. Patients with cerebrovascular disease or peripheral arterial disease are at as high a risk of developing or dying from CHD as many patients surviving their first MI.
Two trials of antihypertensive therapy in patients surviving strokes or transient ischaemic attacks were carried out over 20 years ago. The first, in severe hypertensives, demonstrated a significant reduction in all cause mortality, whereas the other larger study, in milder hypertensives, demonstrated only non-significant reductions in cerebrovascular and cardiovascular morbidity. Further trials evaluating optimal therapy after strokes are in progress. Because acute stroke often induces BP elevation which may last for several days, the timing and threshold for intervention on BP after a stroke remains uncertain. However, if raised BP is maintained once the neurological condition is stable, and severe carotid stenosis is not present, introduction of antihypertensive medication is appropriate. Precipitous falls in BP should be avoided.
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Eat Less Sugar And Industrialized Foods
Industrialized, processed foods, from white-flour muffins to potato chips, and highly sugared foods and drinks can damage our arteries in multiple ways, such as raising triglyceride fats, blood glucose, and inflammatory levels, not to mention packing on the pounds.
Many people dont realize that having type 2 diabetes, the all-too-common result of our highly processed American diet and sedentary lifestyle, dramatically increases the risk of a heart attack. The chance of dying from heart disease for people with diabetes is two to four times higher than those who do not have diabetes.
Another heart attack promoter is a pre-diabetes condition called the metabolic syndrome. The root cause of metabolic syndrome is a poor diet and excess body fat. You have the metabolic syndrome if you have at least three of the following five conditions:
Improving Health With Current Research
Learn about the following ways the NHLBI continues to translate current research into improved health for people with heart disease. Research on this topic is part of the NHLBI’s broader commitment to advancing heart and vascular disease, population and epidemiology studies, and womens health scientific discovery.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.
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Preventing Coronary Heart Disease
Coronary heart disease is the single leading killer of women in the United States, and women with diabetes are at particularly high risk. High blood glucose itself is believed to contribute to this increased risk, but diabetes is also associated with many other coronary heart disease risk factors, including abnormal cholesterol levels, high blood pressure, abdominal obesity, and blood that has an increased tendency to clot.
Symptoms of coronary heart disease can include shortness of breath, nausea, clamminess, cold sweats, unexplained fatigue, palpitations, and chest pain. However, in many cases, coronary heart disease causes no symptoms. In fact, 64% of women who die suddenly of coronary heart disease have no previous symptoms.
Unlike symptoms, however, risk factors for coronary heart disease are readily detectable and in many cases can be controlled. Because coronary heart disease is often fatal, it is essential to prevent it by knowing its risk factors, knowing which you have, and knowing how to lower your risk as much as possible.
A How To Calculate Coronary Heart Disease Risk
Measuring risk requires an interview and physical measurements, some of which need to be recorded on several occasions . Estimating CHD or cardiovascular risk using clinical judgment is imprecise, and while this imprecision is reduced with the use of epidemiological data based on groups, it still remains to some extent at an individual level. Traditionally, guidelines have not addressed CHD risk estimation and leave this to clinical judgment. Such judgment may well have contributed to inadequate efforts at CHD prevention.
The Framingham study results were used in the US NCEP guidelines as an algorithm. This approach has the disadvantage that variables which are continuous and quantitatively related to CHD are treated as categorical variables.
Information required to assess CHD or cardiovascular risk is obtained by asking a few simple questions and measuring BP, total cholesterol, and HDL cholesterol. From the coronary risk chart it is then possible to calculate an individuals absolute risk of developing CHDthat is, the risk of a non-fatal MI or coronary death over 10 years. As risk increases exponentially with age the risk will be closer to the lower decennium for the first six years of each decadefor example, at age 45 the risk will be closer to that at age 40 but at age 47 it will be closer to that at age 50. Family history of premature CHD increases risk by a factor of approximately 1.5 and should also be taken into account in assessing an individuals risk.
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