WOMEN’S HEART HEALTH: HOW IT’S UNIQUE

We know that women and men are different, but sometimes, when it comes to disease, it’s hard to appreciate what that difference means. For example, heart disease is the leading cause of women in Canada dying early. Why is that?

Heart disease affects women differently. Part of that is anatomical; women generally have higher heart rates and smaller hearts and arteries than men. This makes women’s arteries more prone to blood clots or blockages and more difficult to repair.

RISK FACTORS BIGGER THREAT FOR WOMEN

Some risk factors are also a red flag for women. While men and women share most of the same risk factors, some of them, like smoking, diabetes, high blood pressure, and a family history of heart disease, pose an even greater threat for women than for men.

Plus, it’s believed that estrogen protects against heart complications, but once estrogen levels drop during menopause, the risk of heart disease rises. Being older also means women are more likely to have other conditions, such as diabetes, that can further increase risk and complicate a diagnosis.

HEART ATTACK SYMPTOMS DIFFER

Heart attack symptoms can also differ. For both men and women, the most common sign of a heart attack is chest pain or discomfort, but women can experience a heart attack without chest pressure. They may experience shortness of breath, dizziness, lightheadedness or fainting, upper back pressure, or extreme fatigue. Because symptoms in women can be less specific, they can be harder to recognize as danger signs.

BIOLOGICAL AND LIFESTYLE RISK FACTORS

It’s important to educate yourself about your risk factors and talk about them with your health care practitioner. Below are some risk factors to note.

Biological Risk Factors

• High blood pressure
• High cholesterol levels
• Pre-eclampsia (high blood pressure during pregnancy)
• Diabetes
• Atrial fibrillation (an irregular heart rhythm)
• Age – especially after menopause
• South Asian, African, or Indigenous heritage
• Family history of heart disease or stroke/TIA (transient ischemic attack)

 Lifestyle Risk Factors

• Unhealthy diet
• Not enough exercise
• Unhealthy weight
• Smoking
• Birth control or hormone replacement therapy
• Heavy drinking
• Stress

HOW HEART DISEASE IS DIAGNOSED

To diagnose heart disease, your doctor will likely start by asking you about your symptoms, when they began and whether anything makes them better or worse. You’ll also discuss your general health and lifestyle – whether you smoke, your activity level, diet, etc.

For woman it’s also important to discuss whether or not you experienced any pregnancy-related complications. such as preeclampsia or gestational diabetes, and if menopause puts you at a greater risk.

You may be sent for blood work to determine factors like your lipid profile and complete blood cell count. Your doctor may recommend an arrhythmia monitor, electrocardiogram (EKG), or medical imaging.

Cardiac imaging can assess the function, electrical changes, and/or blood flow of the heart. Mayfair Diagnostics provides exercise stress testing, myocardial perfusion imaging (MPI), and coronary computed tomography (CT) angiography to help determine your heart health.

Coronary CT angiography can be used to non-invasively examine the coronary arteries. Using a combination of X-rays and computer technology to produce comprehensive, detailed images, this exam can detect both calcified (hard) plaques and noncalcified (soft) plaques. Patients with family histories of heart disease may be at risk for developing atherosclerotic plaque buildup, blocking or narrowing arteries. On CT, these can be identified even before symptoms of chest pain develop.

HOW DO I GET CARDIAC IMAGING

All cardiac imaging exams are offered at our Mayfair Place location. Exercise stress testing and MPI are covered under your Alberta Health Insurance Plan. Coronary CT angiography is available as a private pay exam, not covered by Alberta Health Care. It can be purchased on its own or as part of a Health Assessment package, which provides a discount on multiple imaging exams when purchased together.

Your health spending account or group medical insurance plan may cover the cost of a private CT that is prescribed by a qualified health care practitioner. You will need to check with your plan administrator for coverage details.

Whether public or private, medical imaging must be requested by a health care practitioner who will provide a requisition. Your medical and family history, risk factors, and type and duration of symptoms, all affect a referring physician’s decision on which type of imaging is appropriate.

When we receive your requisition Mayfair Diagnostics will schedule your exam and provide you with detailed information to prepare for it. Once your exam is completed, your images will be reviewed by a specialized radiologist who will compile a report that is sent to your doctor.

REFERENCES

Donnelly Michos, E. (2022) “Difficult Pregnancies and the Risk of Heart Disease.” www.hopkinsmedicine.org. Accessed May 3, 2022.

Heart and Stroke Foundation of Canada (2022) “Women’s Unique Risk Factors.” www.heartandstroke.ca. Accessed May 3, 2022.

Katella, K. (2022) “Heart Disease in Women: How Pregnancy, Menopause, and Other Factors Affect Risk.” www.yalemedicine.org. Accessed May 3, 2022.

Office on Women’s Health, U.S. Department of Health and Human Services (2021) “Heart Disease Risk Factors.” www.womenshealth.gov. Accessed May 3, 2022.

Sherrell, Z. (2021) “What are the symptoms of heart disease in women?” www.medicalnewstoday.com. Accessed May 11, 2021.