The Practice Pulse Newsletter 2018

Heart of a Woman

With February being coined the “Heart Month” we wanted to share in this addition of The Practice Pulse a common yet frequently misunderstood condition, heart disease in women. Based on the Centers for Disease Control and prevention, here are some facts on women and heart disease:

  • Heart disease is the leading cause of death for women in the United States, killing 289,758 women in 2013—that’s about 1 in every 4 female deaths.
  • Although heart disease is sometimes thought of as a “man’s disease,” around the same number of women and men die each year of heart disease in the United States. Despite increases in awareness over the past decade, only 54% of women recognize that heart disease is their number 1 killer
  • Heart disease is the leading cause of death for African American and white women in the United States. Among Hispanic women, heart disease and cancer cause roughly the same number of deaths each year. For American Indian or Alaska Native and Asian or Pacific Islander women, heart disease is second only to cancer.
  • About 5.8% of all white women, 7.6% of African American women, and 5.6% of Mexican American women have coronary heart disease.
  • Almost two-thirds (64%) of women who die suddenly of coronary heart disease have no previous symptoms.

All women face the threat of heart disease, but the symptoms they experience and some of the risks are unique to women. Heart disease in women cannot be approached identically to heart disease in men. Women are 52 percent more likely than men to experience a meaningful delay in emergency care for heart disease. Additionally, there is an association between heart disease and breast cancer drugs like anthracyclines. Post-menopausal women with metabolic syndrome are at increased risk for cardiovascular events.

Women are more likely to experience a heart attack with atypical symptoms unrelated to chest pain, such as neck, jaw, shoulder, upper back or abdominal discomfort than men. Shortness of breath, pain in one or both arms, nausea or vomiting, sweating, lightheadedness, dizziness or unusual and unexplained fatigue can also be noted.

Unfortunately, the symptoms can be much more subtle than the crushing chest pain often experienced by men. This may lead to significant delays in seeking medical attention. Additionally, women tend to develop blockages not only in the main arteries, but often in the small arteries that supply blood to the heart muscle itself - a condition called small vessel heart disease or coronary microvascular disease.

In women who have coronary microvascular disease, angina often occurs during routine activities such as shopping or cooking, rather than while exercising. Mental stress also is more likely to trigger anginal pain in women than in men.

Heart disease risk factors in women are diverse but include diabetes, mental stress or depression, smoking, sedentary lifestyle, menopause, and complications of pregnancy.

Our recommendations for women are twofold. First, we suggest that everyone maintain a healthy lifestyle which includes quitting or never starting to smoke, exercising regularly, maintaining a healthy weight, and eating a healthy diet as much as possible. Secondarily, it is of paramount importance that any persistent symptom that could potentially be related to cardiac ischemia not be ignored. Any woman who experiences the atypical symptoms outlined above should seek medical attention for evaluation and workup. It is far better to seek medical attention and have it be a false alarm than to wait at home with an active heart attack.

Charles T. Klodell, MD

The Latest Murmurs

“I love the new me. I have a new beginning. Without any warning signs in April 2017 I was told I needed to have open heart surgery and on May 1st, Dr. Charles Klodell at North Florida Regional gave me the opportunity of a lifetime- the chance for a second chance. It was hard work, but what a team- both hospital and surgical staff. I am here working hard to maintain a healthy lifestyle. I am walking 1.5 miles per day. I was given a chance to be a proud new grandmother of my sixth grandchild born on December 30th. Given a chance to celebrate another Valentine’s Day with my sweetheart of 51 years. Wishing everyone a Healthy ‘Mended’ Heart Month. I love second chances.” - Patient, Andrea Dennison

We would like to welcome nurse practitioner Kelly Chewning as the newest addition to the Florida Heart and Lung Institute. Her warm personality and tenacious work ethic coupled with focused patient advocacy will help us continue to deliver the highest level of care to our patients. We are delighted to have her as a part of our team.

Florida Heart and Lung Institute

6440 Newberry Rd, Suite 102 | Gainesville, FL 32605 | Phone: (352) 333-5610 | Fax: (352) 333-5611 | FL Heart and Lung | Email: nfrm.fhli@hcahealthcare.com