Coronary Heart Disease
“Coronary heart disease, also called coronary artery disease, occurs
when plaque builds up on the inner walls of the coronary arteries,”
says David Portugal, M.D., medical director of the catheterization lab
at Memorial Hermann Heart & Vascular Institute–Southwest.
“The arteries are important because they carry oxygen-rich blood to
the heart. Problems occur when the plaque hardens, causing the
coronary arteries to narrow, thus reducing the flow of this oxygen-rich
blood to the heart. The result may be chest pain or discomfort.”
Plaque is composed of fat, cholesterol, calcium and other substances
found in the blood. If plaque ruptures, a blood clot can form on its
surface. A large blood clot can block the blood flow through a
coronary artery. This is the most common cause of heart attacks in
both men and women.
Additional Types of Heart Disease
These other types of heart disease pose a serious risk for women and
are not as well known:
Coronary MVD is a heart disease that affects the heart’s tiny arteries.
A drop in estrogen levels during menopause, combined with other
heart disease risk factors, may be the cause.
Women with coronary MVD experience chest pain or discomfort
often during simple daily activities such as shopping or cooking.
Broken Heart Syndrome is also referred to as stress-induced
cardiomyopathy. The most common symptoms are chest pain and
shortness of breath and the symptoms tend to occur suddenly in
people who have no prior history of heart disease.
“Extreme emotional stress can lead to severe heart muscle failure,”
explains Marco Campos, M.D., a cardiologist affiliated with the
Memorial Hermann Heart & Vascular Institute–Memorial City.
“The symptoms and test results for broken heart syndrome are similar
to a heart attack but the patient will show no evidence of blocked
heart arteries. The good news is that most people have a full recovery.”
Peripheral arterial disease of the legs Peripheral arterial disease (PAD) is also called atherosclerosis. It
occurs when the long arteries in the legs harden and narrow,
limiting blood flow to muscles. The most common symptom is pain
or nagging muscle aches in the legs.
“The body’s circulatory system is interconnected,” says Amilcar Avendano, M.D., an interventional cardiologist affiliated with
Memorial Hermann The Woodlands Hospital. “Individuals with
atherosclerosis of the legs commonly have atherosclerosis in other
parts of the body, putting these patients at increased risk for heart
attack or stroke.“
PAD and coronary heart disease are related; individuals who have
one are likely to have the other.
Risk Factors You Can't Control
Risk factors are conditions or habits that make a person more likely
to develop a disease and some cannot be controlled. According to the
National Heart, Lung, and Blood Institute, having just one of these
risk factors can double your chance of developing heart disease.
For women, age becomes a risk factor at 55. Until menopause, ovaries
produce estrogen that protects women against plaque buildup.
At menopause, ovaries stop making estrogen, increasing a woman’s
risk. With age, arteries get stiffer and thicker.
Women with a father or brother who developed heart disease before
age 55 are at higher risk. Women with a mother or sister who
developed heart disease before age 65 are also at higher risk.
Race and Ethnicity
As a group, African-Americans are more likely to develop high blood
pressure; racial and ethnic minorities are generally more likely to
develop heart disease.
Risk Factors You Can Control
“The older a women gets, the more likely she is to get heart disease,”
says Susan Laing, M.D., director of echocardiography, affiliated with
Memorial Hermann Heart & Vascular Institute–Texas Medical Center. “Although in general, women tend to develop heart disease
about 10 years later than men, this does not hold true for women with
diabetes or women with a significant family history of early heart
disease. In these women, we see heart disease much earlier. Also,
after menopause, women catch up with men with regards to the
likelihood of getting heart disease.”
The good news is that there are lifestyle changes a woman can make at
any age to reduce her risk of heart disease. Among the most
important are following a heart-healthy diet low in saturated fat,
cholesterol and salt and getting regular exercise almost daily.
While traditional risk factors, such as high blood pressure and obesity,
apply to both men and women, some risk factors have a stronger
impact in the development of heart disease in women:
- Diabetes increases the risk of heart disease significantly more
in women than in men.
- Metabolic syndrome (a combination of fat around the abdomen,
high blood pressure, high blood sugar and high triglycerides) has
a greater impact on women than men.
- Mental stress and depression affect women’s hearts more than men’s.
- Smoking is a greater risk factor for women than for men.
- Lack of physical activity increases risk.
Pregnancy complications can increase a woman’s long-term risk of
high blood pressure and diabetes and can increase the risk of
development of heart disease in both the mother and her children.
Heart Attack Symptoms in Women
“The symptoms may be vague and can easily go unnoticed by the
patient,” cautions Ross Brown, M.D., an interventional cardiologist
affiliated with Memorial Hermann Heart & Vascular Institute–Memorial City. “In this case, we aren’t dealing with blockages in the
arteries as in a typical heart attack.”
Symptoms in women may include:
- Neck, jaw, shoulder, upper back or abdominal discomfort
- Shortness of breath
- Pain in the right arm
- Nausea or vomiting
- Dizziness, lightheadedness
- Unusual fatigue
Women and men alike may ignore heart attack symptoms because they
mistakenly think that the discomfort will pass or that they would never
have a heart attack. Some are even embarrassed, thinking, “What if it
turns out to be nothing?” Don’t take the chance. If you or a family
member experience these symptoms, or think it could be a heart attack,
immediately call 9-1-1.
To find a Memorial Hermann-affiliated cardiologist or cardiovascular surgeon use our online ScheduleNow tool or call (713) 7CARDIO.