Dr. Seibel's Health Tips / Health and Fitness

Heart Disease and Menopause

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Cardiovascular heart disease (CVD) is the number one killer in women over age 65 and the second leading cause of death among women ages 45 to 64. More women die from cardiovascular disease than all other causes of deaths such as lung cancer, breast cancer, stroke and COPD (chronic obstructive pulmonary disease) combined. So, it’s a critical issue in health care today, and every woman needs to be aware of that.

Menopause seems to play and important role in CVD because of lower levels of estrogen. Women who go prematurely go through menopause at a younger age have an even higher rate of heart disease. New studies such as the KEEPS (Kronos Early Estrogen Prevention Study) are showing that if estrogen is started within a few years after the beginning of menopause, there is not an increase in the risk of heart attack or stroke.

When the subject of heart attack is discussed, most women think of crushing chest pain or pain that radiates down the left arm. But women tend to present with atypical symptoms when they’re having a heart attack. They are more likely to feel profound fatigue, shortness of breath, and less than half of them will have the classic chest pain. That’s why many women don’t realize they are having a heart attack, and even if they go to the emergency room, the diagnosis is sometimes missed.

Traditional risk factors for CVD include high cholesterol, high blood pressure, diabetes, sedentary lifestyle, and poor diet. Additional risk factors for CVD in women include autoimmune disorders such as lupus and rheumatoid arthritis, and pregnancy-related disorders such as gestational diabetes, pregnancy-induced hypertension and preeclampsia. Women who have any of these things are at more risk of having heart disease and even heart attack.

What makes diagnosing heart disease in women so challenging is that the usual tests do not apply for women. For example, in men, CVD is diagnosed by doing an angiogram test in which a small catheter is placed through a vein and thread into the heart arteries where a small amount of a dye is injected to see if the big arteries are blocked. If there is a blockage, a stent can be used to open the blockage.

Over 50% of women who get a catheterization will have no blockage found, but they still have persistent chest pain and persistent symptoms. They are then falsely reassured that they don’t have heart disease. However, the fact is that they do have heart disease, but instead of the larger heart arteries being affected, the disease is in the small arteries of the heart. This is called microvascular disease or microvascular dysfunction. It puts them at a higher risk for a heart attack even though the larger arteries are open.

So when there are persistent symptoms like chest pain, shortness of breath, extreme fatigue or back or jaw pain with exertion, women should tell their medical provider, and the provider should consider ordering tests that may include an exercise treadmill test and possibly other tests such as a stress echo test (that uses ultrasound to test the heart while you are on a treadmill), a Single Photon Emission Computed Tomography (SPECT) scan, which is a nuclear imaging test that shows how blood flows to the heart, an MRI or a Positron Emission Tomography or PET scan that injects a small amount of radioactive material into a vein to look for abnormal blood flow.

Remember, even if your large cardiac arteries are open, if you continue to have symptoms, microvascular and/or endothelial dysfunction should be considered and tested for.

Until next time,

Dr. Mache Seibel, Founder of My Menopause Magazine http://bit.ly/MyMenoMag

Professor, University of Massachusetts Medical School

Founder My Menopause Magazine

© 2012 HealthRock, LLC. HealthRock Publishing ASCAP All Rights Reserved
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Editor’s Note:
As Dr. Seibel says, "It’s better to stay well than to get well!" Visit his award-winning site at www.doctorseibel.com.

Did you know? Have you seen it yet? Happy to announce Dr. Seibel’s new "magazine," My Menopause, is now available for all to view.  Just click here

“It’s better to stay well than to get well!”  Mache Seibel, MD.

Dr. Machelle (Mache) Seibel is America’s health expert, addressing the critical needs of consumers from stress and weight control to menopause and beyond. He served on the Harvard Medical School faculty for almost 20 years and is a pioneer in many areas of women’s health and more. He works with companies and organizations to bring exciting educational content to consumers. His professional experiences include:

– Host for PBS and NBC TV episodes, frequent media expert;

– Repeatedly voted into Best Doctors in America;

– Past Editor-in-Chief of the medical journal Sexuality, Reproduction & Menopause;

– Distinguished Alumnus Award, the University of Texas Medical Branch’s highest honor 2008;

– Multiple national awards for research, writing, music writing and patient education;

– Professor, University of Massachusetts Medical School 2004-present;

– Director, Complicated Menopause Program, University of Massachusetts Medical School 2004-2011;

– Founder of HealthRock®, reshaping health education with health songs and entertainment;

– Past Medical Director, Inverness Medical Innovations (now Alere);

– Corporate Consultant and Corporate Health Expert Nationally and Internationally;

– Author/editor 14 books, over 200 scientific articles;

– American Cancer Society New England Division Medical Advisory Network;

– Advisory board of Dr. Mehmet Oz’s HealthCorps initiative to fight childhood obesity; and

– Nationally known guest speaker, key note speaker.

Visit his award-winning website www.DoctorSeibel.com and sign up for his free monthly newsletter.

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