Women’s Heart Disease Facts: Knowing the Signs and Symptoms

Intro: This is Weekly Dose of Wellness brought to you by MemorialCare Health System. Here's Deborah Howell.

Deborah Howell (Host): And welcome to the show. I am Deborah Howell and today we'll be talking about women and heart disease. Our guest today is Dr. Rachel Hargrove, a cardiac surgeon with the MemorialCare Heart and Vascular Institute at Orange Coast Medical Center and Saddleback Medical Center. Welcome Dr. Hargrove.

Rachel Hargrove, MD: Thank you.

Deborah Howell (Host): Very, very nice of you to join us today. Now, it's a fact that women are more likely to die from heart disease than men. Cardiovascular disease and stroke cause one in three women's deaths each year. But about 80% of heart disease and stroke events may be prevented by lifestyle changes and education. So today, we're going to talk about some of those myths about women's heart disease. First of all, Doctor, what causes heart disease?

Rachel Hargrove, MD: So, heart disease is caused by a process called atherosclerosis. And that is a buildup of fat and cholesterol and other substances in the lining of the blood vessels that form what we call plaque. This plaque narrows the arteries and makes it harder for the blood to flow through the arteries. Once the plaque forms, uh, sometimes a clot can develop and that can actually stop blood flow, causing a heart attack or stroke.

Deborah Howell (Host): Got it. Now, it's a common perception that men are more likely to be affected by heart disease than women. Now, is that true?

Rachel Hargrove, MD: So, that is true, men are more likely to be affected. However, heart disease is the number one killer of women. So, you'd mentioned earlier, it causes one out of every three deaths of women each year. So, it's approximately one woman every 80 seconds dies from heart disease. It's estimated that there's 44 million women in the United States that are affected by heart disease. Another statistic that's - that's alarming is that fewer women than men survive their first heart attack.

Deborah Howell (Host): That is alarming. So let's get into it. How do symptoms of a heart attack present differently in women? And what are some of the symptoms commonly mistaken for?

Rachel Hargrove, MD: Some heart attacks can come on suddenly and be abrupt and intense, others can come on quite slowly with mild symptoms. And in women, they have a tendency to underestimate what they're feeling, in the sense that they will attribute it to other things and not their heart. So, common symptoms, of course, number one is always chest discomfort. This can be pain, but often in women, it's a pressure or squeezing, a tightening of a band around their chest. It also can be pain or discomfort in other areas, like their back or both of their arms or neck. Other symptoms that are mistaken as - as other illnesses in women can be shortness of breath. The shortness of breath can occur with or without chest pain. Additional things can be having a cold sweat, nausea or feeling lightheaded.

Deborah Howell (Host): Wow, no wonder they think it's something else. I mean, you've got a pain in the back and you're sweating, you wouldn't necessarily think, "Oh, heart attack."

Rachel Hargrove, MD: No, often women think that they are feeling tired, uh, that they've overextended themselves, they've taken on too many responsibilities, or that they're just coming down with a cold. But these - symptoms, the shortness of breath and the nausea, uh, and fatigue and chest pressure or pain can all be symptoms of heart attack.

Deborah Howell (Host): Really good to know. What increases the risk of developing heart disease?

Rachel Hargrove, MD: So, there are several risk factors of - of developing heart disease. There are some that can be managed, i.e. modified, and there's other risk factors that you can't control. Risk factors that you can't control are things like your age, being a female, your family history, or having a previous uh, stroke or heart attack. But things that can be managed and treated are things such as high blood pressure, smoking, high cholesterol, lack of regular activity, leading a sedentary lifestyle, obesity and diabetes.

Deborah Howell (Host): Okay then. Let's talk about those recommended lifestyle changes that can help us all prevent heart disease.

Rachel Hargrove, MD: Yeah, so the lifestyle changes focus on the risk factors that I mentioned that can be managed and can be altered. So, some of the most important things are to not smoke and then to make sure that you consult with your doctor and check things like your blood sugar and your blood pressure. You want to keep your cholesterol low. Also, you want to know your family history, so talk with your family and see, is there anyone in our family that's had heart attacks or stroke? And then on a daily basis, you can stay active. Exercise is recommended five days a week, at least 30 minutes of a moderate exercise, or if you do more strenuous exercise, you can do it for fewer days in the week, but with a more strenuous emphasis. So, the bottom line is to stay active, keep a healthy weight, and that would be a BMI of under 25, and then of course, eat a healthy diet.

Deborah Howell (Host): Got it. I mean, it sounds pretty easy, but it can be a little difficult when you, you know, you have a birthday and there's that big chocolate cake in front of you, but everything in moderation and have a treat once in a while, but generally just stay healthy, right?

Rachel Hargrove, MD: Yes, when it comes to eating healthy, we recommend what's called a heart-healthy diet. And the heart-healthy diet is something you can look up online, it's, you know, promoted by the American Heart Association, and it has an emphasis on a balanced diet that includes lots of fruits and vegetables, lean meats and whole grains.

Deborah Howell (Host): Right. Okay. Now, if a woman feels like she may be experiencing signs of heart disease, what should she do?

Rachel Hargrove, MD: So, if she's having symptoms or is just concerned that possibly what she's feeling could be like these symptoms, then she should seek consultation with her doctor immediately. If their office is not available, or if she thinks that she is having a heart attack or stroke, then the woman should go directly to the closest emergency room. All emergency rooms are equipped to diagnose and treat heart attacks and strokes uh, if they are occurring. And so, the treatments are widely available and early intervention if someone is having a heart attack or stroke is key. So, I would say the bottom-line message is if you think you're having a heart attack or stroke, to not wait and to go immediately to the doctor, including the closest emergency room.

Deborah Howell (Host): And don't drive yourself, if possible.

Rachel Hargrove, MD: No, don't drive yourself. Yeah, they've found that women often the first thing they do when they're having some of these symptoms is they call their mother, or they call their sister, they call another woman in their life and they say, "I'm having this shortness of breath," or "Oh, I'm just having this awful uh, you know, pain or nausea, it won't go away." You know, it's important to reach out to your family, but I would encourage, and hopefully through awareness campaigns such as this, to have women go and seek medical attention immediately.

Deborah Howell (Host): Okay, got it. Now, why are women more likely to die from heart disease than men?

Rachel Hargrove, MD: Now, that is a complex question that as physicians we're trying to understand more about, but it seems to be related to the lack of awareness of how women's heart health differs from men, particularly in the presenting symptoms. Not only for the general public of women recognizing their risk and knowing, "Oh, these symptoms may be part of cardiovascular disease, that I may be having a heart attack or stroke," but then also on the part of the healthcare practitioners, where we are not as good at recognizing symptoms that maybe a woman comes to our office with and says, "I keep having these symptoms of shortness of breath or nausea." We don't recognize it as often as they may be early warning signs of heart disease. So overall, you know, we think that we can reduce that gap between women and men, with respect to having deaths from cardiovascular disease if we raise awareness of how it affects women and what to do, and if you have symptoms, to seek help early.

Deborah Howell (Host): Okay, got it. I have a last question for you, Doctor. What are some ways women can be more aware of their heart health?

Rachel Hargrove, MD: Yes, so to become knowledgeable about this, I think the first thing is to have a conversation with your primary care doctor. Now, this can be a family medicine doctor, it can be the internist, or it can be your OB/GYN. But you should ask questions regarding your heart, and they will help you to understand what are your risk factors and guide you and counsel you in how to reduce those risk factors.

Deborah Howell (Host): Always starts with a first step to your doctor and a trusted doctor, one who knows you, who knows your family is always best, right?

Rachel Hargrove, MD: Correct.

Deborah Howell (Host): Okay, Doctor, thank you so much for being on the show today, we really appreciate your time.

Rachel Hargrove, MD: Yes, thank you for having me.

Deborah Howell (Host): We learned a lot and we're gonna go take care of our hearts, right ladies? And gentlemen. All right, for more information or to listen to a podcast of this show, please go to memorialcare.org. That's memorialcare.org. That's all for this time. I'm Deborah Howell. Thanks for listening and have yourself a great, healthy day.