Coronary Artery Disease (CAD): What Women Should Know
Fellowship in Heart Failure and Echo (Australia)
Senior Consultant – Interventional Cardiologist
Coronary Artery Disease (CAD), which involves cholesterol build-up on the inner wall of the heart blood vessels, is a common cause of death for both men and women. When a sufficiently large plaque prevents the blood vessels from providing sufficient oxygen to the heart, chest pains and a heart attack ensue. CAD can also lead to a chronic heart failure, Arrhythmia (electrical abnormality) and sudden death (SCD). While women tend, on average, to develop CAD a decade after men, it remains the primary cause of death.
Women tend to suffer from microvascular diseases, where the tiny vessels of the heart incur damage without any major build-up of cholesterol occurring. This is believed to occur because of the decline in blood oestrogen levels after menopause. Women also tend to delay seeking medical advice on their symptoms (due to familial commitments), seeking treatment only when the condition has become severe.
By paying attention to the various controllable risk factors that lead to coronary diseases, the probability of developing heart-related diseases can be reduced. These factors include high blood pressure, diabetes, smoking, high cholesterol (Dyslipidemia), obesity, a sedentary lifestyle, stress, and alcohol consumption.
On the other hand, other some risk factors like age, gender, family history and broken heart syndrome cannot be controlled. Broken Heart Syndrome is more common in women than men, and occurs when severe emotional stress causes a severe heart muscle pumping function (Stress Cardiomyopathy or Takotsubo Cardiomyopathy).
Women are also exposed to other factors that elevate the risk of heart diseases, such as complications caused by a pregnancy (e.g. Gestational Diabetes and Preeclampsia), hormonal changes and birth control pills.
Post-menopausal women are also more at risk for heart diseases, possibly due to the change in hormonal patterns. Diseases like Lupus and Rheumatic Arthritis are also associated with an increased risk of heart disease in women.
Heart attack symptoms
Typical heart attack symptoms include chest pains, sweating, arm pains, a strange feeling in the chest, shortness of breath, an accelerated heartbeat and light-headedness. Atypical symptoms include stomach pains with vomiting, alongside tooth and jaw pains.
Reducing the Risk of Heart Disease
Heart-related diseases can be avoided by practicing healthy eating habits and exercising regularly (e.g. a 30 min walk for at least 5 days of the week). The regular consumption of fruits and vegetables and the reduced consumption of red meat, ghee, and butter is encouraged.
Individuals are also encouraged to reduce their alcohol consumption, to quit smoking, and to undergo regular medical check-ups after reaching 30 (every two years). Those over 40 years old are encouraged to undergo a medical check-up each year.
Besides fruits and vegetables, the regular consumption of nuts, flax seeds, lean meat, fibrous foods, and foods rich in omega 3 fatty acids (olive and fish oils, fish, nuts and flax seeds). Salt, added sugar, saturated fats, trans fat, refined grains, oil, fat, coconut oil, deep fried foods, baked goods and cheese should be avoided.
High levels of stress are also correlated with an elevated risk of heart disease. Stress levels can be reduced by spending time with family and friends, meditation, listening to music, practicing yoga and reading.