More on Women and Heart Disease
The following is a response to my FWDS from a woman who, as you will read, has had heart problems for a number of years.... she is NOW only 55 years old. I asked her permission to send her comments to me on to others. The following is her response to me:
Thanks for sending this out. It is true that a conventional stress test isn't completely trustworthy for women; at least the results can't be interpreted the same way as they are for men. The EKG test also only goes so far -- mine are always normal, despite having two leaking heart valves and an irregular heartbeat. My symptoms didn't fit many of the stereotypes, and the most difficult thing to understand is that angina (heart-caused chest pain) isn't really that painful -- it's more just kind of uncomfortable. It took me a month of having this discomfort daily to finally figure out that something was seriously wrong. I think what made me realize it was serious is when I began to consistently have this weakness and uncomfortable feeling in my chest every time I did any kind of exertion, climbing stairs, walking fast, or even carrying a bag of groceries. It was confusing though, because I was never short of breath (a symptom I thought always went along with heart disease), and I was very physically fit (I was going to the gym three times per week). Even with the description of my symptoms, the doctor I saw the first time told me there was a 5000 to 1 chance against it being heart disease due to my age and total lack of any risk factors. Thankfully, he went ahead and ordered the tests anyway, telling me it was always a good idea to rule out the most serious possibility first.
The test that is much, much better for women is called a stress-echo. This is the standard stress test, plus an echocardiogram which shows the movement of the heart muscle and valves. They can tell from this test if your heart muscle is receiving enough blood during exercise, which can show if you have blocked arteries. If you do poorly on this test, they do an angiogram which will definitively show any blockages. The echocardiograms they do now are kind of like an ultrasound, and you can see not only the movement of the heart walls and valves, but the blood is colored red or blue as it moves through the heart so you can tell if there is any heart valve leakage, and how much leakage.
Of course, blocked arteries don't directly cause heart attacks, blood clots do. If your arteries are narrowed, it is easier for a blood clot to get stuck and cause a complete blockage. Even a 40% blockage is serious according to my cardiologist, as these blockages can rupture which then causes a blood clot and a heart attack. Our hearts are very strong, and most people don't feel the effects of a blockage until it's more than 70%. Thankfully they have some really good medicines that can actually reverse the formation of blockages. Thanks to these drugs, the area of artery that required my bypass surgery is now mostly open, with blood circulating through it ( I guess you could say instead of a bypass, I now have a back-up artery).
Susan: Would you mind if I shared this email with a few others? Your description of what you experienced is just what we need to know.
Sure! It's pretty hard to figure out what's really happening sometimes. I've had six angiograms over the past 10 years due to chest pain -- three times it turned out to be a heart problem and three times it was something else. However, all six times it felt the same to me! Had I not gone to the doctor, I'd surely be dead or at least have had a full-blown heart attack by now. Unfortunately, once you have documented heart disease, they pretty much pull out all their bag of tricks if you go to the emergency room. It's too bad they didn't have an easier test for finding out what's really happening. (Maybe they should just put a little valve in my leg so they could tap in any time they need to!)