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Heart disease – also called cardiovascular disease –refers to conditions that involve narrowed or blocked blood vessels that can lead to a heart attack, chest pain or stroke. Heart disease is the leading cause of death for both men and women in the United States, but more women than men die of heart disease each year. That's why at The University of Vermont Medical Center, we offer a heart disease program tailored specifically to women's unique symptoms and risk factors.
Women and Heart Disease Care at UVM Medical Center
At The UVM Medical Center, we provide a caring, personal approach to every woman we see. You can expect:
- Attentive, focused care - We spend as much time with you as you need - answering all your questions and working together to develop a treatment plan that works for you, all the while keeping in mind that treatments for women with heart disease can be quite different than for men.
- Regional excellence - We're one of the leading heart programs in the region. This means our female patients work with highly trained and experienced cardiologists who are on the frontiers of cardiac medicine.
- Evidence-based options - As a university hospital, our doctors use the latest research and heart health developments to inform the care we provide every day. You will have access to the most recent heart disease treatments and technologies available.
- Diagnostic accuracy - Understanding the cause and severity of your heart disease is critical to determining the appropriate treatment. Our cardiologists offer a broad range of diagnostic exams, including advanced technology options like our CT scanner, to quickly and accurately diagnose heart disease in women.
Heart Disease in Women: An Overview
The most common type of heart disease is coronary heart disease, in which a waxy substance called plaque builds up inside the coronary arteries reducing the flow of oxygen-rich blood to the heart. Hardened plaque narrows or blocks the coronary arteries.
Women tend to have blockages not only in their main arteries but also in the smaller arteries that supply blood to the heart - a condition called small vessel heart disease or coronary microvascular disease.
In the United States, 1 in 4 women dies from heart disease. Part of the problem is that women's heart disease symptoms can be different from heart disease symptoms in men.
Signs of a heart attack in women can be more subtle than the crushing chest pain often portrayed in movies. Symptoms may include:
- Neck, shoulder, upper back or abdominal pain
- Shortness of breath
- Nausea or vomiting
- Lightheadedness or dizziness
- Unusual fatigue
Traditional heart disease risk factors affect both women and men, such as:
- High blood pressure - elevated level of pressure against the arteries
- High cholesterol - increased levels of fat (lipids) in your blood that can build up in your arteries
- Obesity - maintaining a level of body fat that is harmful to your health
- Diabetes - a condition where the blood glucose levels are higher than normal
However, other factors may play a bigger role in the development of heart disease in women, including:
- Smoking - UVM Medical Center offers a quit smoking program.
- Metabolic syndrome - characterized by too much fat around the waist, elevated blood pressure and blood sugar levels, high triglycerides (fat in the blood), and low HDL (“good”) cholesterol
- Depression - an illness causing sadness, low energy, and loss of interest in activities
- Mental stress
- Low estrogen levels after menopause
Additionally, women under the age of 65 who have a family history of heart disease should pay particularly close attention to heart disease risk factors.
There are several lifestyle changes women can make to reduce their heart disease risk:
- Follow a healthy eating plan rich in fruits, vegetables and lean proteins such as fish, chicken and beans and low in saturated fat, cholesterol, and salt
- Get 30-60 minutes of physical activity on most days of the week
- Aim for and maintain a healthy weight
- Quit smoking - The UVM Medical Center offers a quit smoking program.
Diagnosis for Heart Disease
It's likely your physician will start your diagnosis with a conversation about your personal and family medical history, symptoms and a physical exam. Based on your symptoms and physical exam, your doctor will order tests to accurately diagnose your condition.
The UVM Medical Center's cardiologists, doctors specializing in heart problems, are specially trained in advanced technology to diagnose women with heart disease.
- An echocardiogram is a noninvasive test using ultrasound waves to evaluate your heart's structure and blood flow. A computer translates the ultrasound waves into an image of your heart. The image is displayed on a monitor, and it can be recorded on videotape or printed on paper.
- EKG or ECG (Electrocardiogram) is a painless test using patches with wires (called electrodes) attached to your chest to measure your heart's electrical impulses. The electrodes are hooked up to a machine that displays or prints your heart's electrical activity.
- Cardiac catheterization and biopsy is a procedure where a thin flexible tube (cardiac catheter) is inserted in your groin (femoral artery). Then the catheter is threaded through your blood vessels to your heart, where a small tissue sample (biopsy) is removed for later analysis in the laboratory. Also, this test can measure how forcefully blood pumps through the chambers of your heart and can take pictures of the heart's arteries (coronary angiogram) to see if you have any blockage.
- Cardiac Magnetic Resonance Imaging (MRI) is a diagnostic imaging technique that uses magnetic fields and radio waves to make images of your heart.
- Cardiac computed tomography (CT) is a technology for scanning the heart using an X-ray that takes cross-section pictures (slices) of the body. The slices are put together to create a 3D image. A machine that takes more slices creates better quality images. Our machines take between 64 and 256 slices.
- Holter monitoring uses a portable machine to record all of your heartbeats.
- Blood tests help your doctor determine the cause of your symptoms.
- Chest X-ray is a picture of the chest that shows your heart, lungs, airway, blood vessels, and lymph nodes.
Heart Disease Treatments
The goal in treating women with heart disease is to open narrow arteries or bypass blocked arteries that cause your symptoms. In some women, plaque builds up as an even layer along artery walls. That type of plaque isn't treatable using procedures such as angioplasty and stenting, which are instead designed to flatten bulky, irregular plaque. For these women, medications or bypass surgery may be a better option.
At The UVM Medical Center, all treatments are personalized to your condition. The results of your diagnostic testing and other factors determine the course of action your team of physicians recommends.
Treatment options for women with heart disease at The UVM Medical Center include:
Even if you still need medications or bypass surgery, your cardiologist is likely to prescribe lifestyle changes to treat women with heart disease, including:
- Healthy Eating - Follow a heart-healthy eating plan that focuses on what you can eat. Try fresh fruits, vegetables and lean proteins. There are some foods to avoid when you're eating heart healthy. Read food ingredient labels and limit your daily intake of saturated fats and salt. Remember there is more you can eat than what you shouldn't.
- Physical Activity - Get at least 30 minutes of physical activity, where your heart is pumping, most days of the week. Splitting up the time into 10-15 minute sections is okay as long as your total reaches 30-60 minutes by the end of the day. Try easy ways to increase your daily physical activity such as parking further away from the entrance of stores and walking. Or take the stairs instead of the elevator.
- Aim for and Maintain a Healthy Weight - Start by calculating your Body Mass Index (BMI). A BMI of 25 or higher is associated with an increased risk for heart disease. Then try losing 10 - 15 pounds at the rate of one pound a week. Once you achieve a healthy weight/BMI, maintain it with the other lifestyle changes described here.
- Quit Smoking - Women who smoke are at a greater risk for heart disease than men. We know quitting can be hard. That's why we offer a quit smoking program.
Certain heart disease medications, such as thrombolytics tend to be more effective in women than in men.
Since angioplasty and stenting are not as effective in treating women with heart disease, a more invasive procedure may be necessary. Bypass surgery uses a vein from another part of your body - usually your leg - to allow blood to flow around the blocked section of the artery.