Dr. Rajeshwari
Fellowship in Heart Failure and Echo (Australia)
Senior Consultant, Interventional Cardiologist
Coronary Artery Disease (CAD) is a major killer disease in both men and women. CAD is a disease in which cholesterol deposits on the inner wall of the heart blood vessels. These blood vessels carry oxygen to the heart. When a plaque builds up, the oxygen does not reach the heart in adequate amounts causing chest pain and a Heart Attack.CAD can also cause Heart Failure, Arrhythmia (electrical abnormality) and sudden death (SCD). Women tend to have CAD 10 years later than men but CAD remains as the number 1 killer.
Women are more prone to small vessel disease where in the tiny vessels of the heart are diseased or damaged without major cholesterol deposits. It is thought that fall in oestrogen levels during menopause along with conventional risk factors cause microvascular disease in women. Although the death rate from heart disease has dropped significantly in last few decades, not much reduction has been seen in women. Coronary microvascular disease and broken heart syndrome are more seen in women than men.
Women tend to ignore their symptoms because of family commitments like husband’s office work, children’s exam etc. Many a time initial symptoms are ignored and they seek advice only when the problem is more severe.
The risk factors for a Heart Attack
Risk factors are conditions or habits that raise the risk of Heart Attacks and Coronary Diseases. The good news is that by controlling the risk factors, Heart Attacks can be reduced
Controllable risk factors:
- High Blood Pressure( Hypertension)
- Diabetes
- Smoking
- High Cholesterol ( Dyslipidemia)
- Obesity
- Sedentary Life Style
- Stress
- Alcohol
Uncontrollable risk factors:
- Age
- Gender
- Family history
Broken Heart Syndrome
In this condition, women are more prone than men. Here, severe emotional stress can lead to a severe heart muscle pumping function also known as Stress Cardiomyopathy or Takotsubo Cardiomyopathy.
Women also have certain other factors which can raise the risk of Heart Disease- they are pregnancy related complications, hormonal and birth control pills.
Menopause
Women are more at risk of Heart Disease after Menopause. The exact reason is not understood. The change in hormonal pattern is thought to play a role.
The risk of heart disease are more in women who are on hormonal pills and the risk doubles if the person is a smoker.
Using birth control pills can increase the risk of heart disease if the person is above 35 years of age with strong family history of CAD. Pregnancy related problems like Gestational Diabetes and Preeclampsia can increase the risk of heart disease and stroke later in life.
Certain disease like Lupus and Rheumatic Arthritis are associated with increased risk of heart disease in women.
Heart attack symptoms
- Chest pain: discomfort, heaviness, uneasiness, burning
- Atypical symptoms: stomach pain with vomiting, jaw & tooth pain
- Sweating and arm pain
- Increases on walking
- Discomfort which repeats
- strange feeling in the chest
- Sweating
- Shortness of breath
- Fast Heart Beat
- Light headedness
In women many a times symptoms are atypical, hence they try to ignore them
How can you reduce risk:
- Healthy lifestyle
- Heart healthy foods: plenty of fruits and vegetables, less red meat, less ghee, butter
- Regular exercise: 30 minutes walk for at least 5 days a week
- Healthy weight: height in cms minus 100 will give a person’s ideal weight
- No smoking / alcohol intake
- Regular check up after 30 years of age
Lifestyle changes for healthy heart
- Healthy diet
- Physically active
- Maintaining healthy weight
- Managing stress
- Quitting smoking
Healthy diet:
- Plenty of fruits & vegetables
- Less oil ( 500 ml per person per month)
- Avoid ghee, butter, cheese, red meat
- Sun flower, Olive, Rice Bran, Canola, Gingily oil can be used
- Healthy snacking: almonds, walnuts, pistacchios, ground nuts, fruits & vegetables
- Flax seeds, walnuts for good cholesterol
Healthy foods:
- Food rich in omega 3 fatty acids : olive & fish oils, fish, nuts & flax seeds
- High fibre foods : whole grains, fruits, vegetables
- Lean meat : chicken without skin , egg white
- Low in salt & added sugar
- Low in solid fats : saturated & trans fats
- Low refined grains : maida which removes dietary fibre & nutrients
- Less in oil, fat, red meat
- No mutton, beef, pork
- No ghee, butter, cheese
- No coconut and coconut oil
- 500 ml of oil per person per month
Unhealthy foods:
- Red meat
- Deep fried foods
- Bakery products
- Cheese, butter, ghee
Being physically active:
- Healthy diet with regular exercise
- 30- 40 minutes of walk every day
- Height in cms minus 100 : ideal weight
- Lowers cholesterol & increases HDL
- Maintains ideal bodyweight by burning calories
- Controls BP
- Controls blood sugar level
- Reduces the need for medications
Smoking
- 1 in every 5 death is due to smoking
- Smoking is the main preventable cause of death
- Smoking harms every organ in our body
Stress
- Very important risk factor for heart attack
- Stress following fight in the family and office
- Meditation, music, yoga, reading can help reduce stress
Prevention of heart attack
- Health check after 30yrs, every 2 years
- After 40years every year
- BP <140/80 mm of Hg
- Weekly blood sugar monitoring for diabetics
- FBS
There is significant development in the treatments available for Heart Attack. When patients come with a heart attack within one hour the blocked artery can be opened, what we call Primary Angioplasty. However patients tend to ignore symptoms thinking that it is only a gas problem. My advice to all women would be- whenever anyone or family member experiences chest pain, go to the doctor and get an ECG done. But more stress should be on prevention.