Heart disease remains the leading cause of death for women. Underdiagnosis is a major reason.
Dr. Katy Fetten, a cardiothoracic surgeon at Baylor Scott & White Dallas, tells KERA's Sam Baker heart disease doesn't present the same way for men and women.
Dr. Fetten: A lot of these cardiovascular studies were done in men. So, the crushing sub-sternal chest vein, the elephant on the chest is how men present.
Women are a little more subtle. They have fatigue. They have shortness of breath. They might have some back pain.
So overarchingly, because of these subtle symptoms, women have to truly be aware that something is going on and have to advocate for themselves in the process.
Baker: But we're so far advanced in diagnostic technology, shouldn't we be beyond this?
Dr. Fetten: I absolutely agree with you. And I do think that some of the technologies such as calcium scoring and some of them less-invasive aspects of care have caused us to advance a bit, but I think we still need to get the women in the door. Start worrying about their own health, stop putting themselves last and everybody else first, and actually, actively advocating for themselves in the process because you still need to walk in the doorway to have those tests done.
Baker: So, then you need to be very much aware of the early signs and what they are.
Dr. Fetten: And I think increasing awareness is one of those things that is incredibly important and really focusing on what women may experience.
There is something called a silent heart attack that a woman may experience.
So, indigestion, flu-like symptoms, sort of a strained muscle of the upper back and chest, maybe some discomfort in the jaw, but it is truly a sign of a heart attack. Just because it is silent doesn't mean the blood flow isn't decreasing to the heart muscle.
So, it's really truly still an emergency, but it could be silent and a woman could just be feeling a little off.
Baker: Does a delayed diagnosis affect the likelihood and or success of surgery?
Dr. Fetten: Well, it does delay diagnosis. Now, depending on how much damage has been done to the heart muscle, that sort of depends on the risks moving forward with surgery.
So, if the squeeze of the heart or the ejection fraction is still normal on that left side, oftentimes, even if some damage has been done, there's no increased risk with surgery, I think the risks do increase though as soon as you have a lower ejection faction or what we call heart failure.
And so, it's all about finding the issues in a timely manner so that we can then move forward and sort of address them before it becomes an issue.
Baker: Tell me about something some call it SCAD, some call spontaneous coronary artery dissection.
Dr. Fetten: Spontaneous coronary artery dissection is a disease state that impacts women more often than men. It is essentially a tear in the artery that supplies blood to the heart. And it is something that is a challenge to manage. It often requires a multidisciplinary approach.
Now, we've been pretty successful with that. We had a woman recently who suffered SCAD, then ended up on some support. So, an impella device , which was a mechanical support device, then ended off utilizing a left ventricular assist device.
And then after stabilization, we were able to get her to heart transplantation. And she's done remarkably well with this.
And I think that kind of demonstrates what we can do when we work together in a multidisciplinary fashion. And how far our care really has come at this point.
RESOURCES:
10 Sneaky Signs You May Have Heart Disease
The slowly evolving truth about heart disease and women
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