The hearts behind the giving

Valentine’sDayisacelebrationofloveandthe exchangeoftheuniversalsymboloftheemotion— theheart.Onthisday,heartsaregiventoothersin everyimaginableway.Heartsareoncards,balloons, madeoutofflowersandchocolate,drawn,painted, andetched.Theuniversalsymbolcrossesborders andoceans,allthewhilemaintainingitsmeaning. Althoughthesymboloftheheartisnotreflectiveofthe anatomicalheart,it,too,variesinsize,shapeandcolor.

ThesentimentbehindValentine’sDayistoshow otherstheyareloved,appreciatedandadmired.

AsIimaginethedifferencesbetweenhowmen andwomencelebratetheday,moreoftenthannot, womenaretherecipientsoftheseexpressionsof love.Imaynotbeabletoexplainthemotivebehind thesedifferencesbutwillsticktothephysiological differencesintheheartsbehindthegiving.

Bynatureofsize,awoman’sarteriesandvesselsare smallerandtheirheartbeatis8-10beatsfasterthana man’satrestwiththefemalehormone,estrogenbeing themainfactorbehindthesebiologicaldifferences. Womenandmenfacesimilarrisksyettheirdisease processespresentdifferently,andthediagnostics andtreatmenttheyreceiveisspecifictonotjusttheir medicalhistorybuttotheirgender.

Aswepayspecialattentiontothosewelovethis monthonValentine’sDay,especiallythewomen inourlives,letusberemindeditisnotjustthe emotionalheartwecareabout,butthehealthoftheir hearts and bodies that meanthe most.

Yours,

Gender makes a difference

Q: Heart Disease is the No. 1 killer in women. What factors contribute to this?

Whenever you think of cardiovascular disease you think of men as the flawed, but on any given day in the ICE cardiac catheterization labs there are more woman than men. Risk factors are the same in both males and females regarding smoking, hyperlipidemia (too many lipids—or fats —in the blood), diabetes and high blood pressure.

Women face an increased plaque burden, diffuse nature of arterial disease and smaller caliber of the peripheral and coronary arteries. Additionally, there is more of an atypical presentation in woman than in men, whereas men typically present with angina. Peripheral arterial disease is also atypical in woman and can present as discomfort in the legs or in the heel that is present at rest or during exercise or may not be confined to the muscle.1

Q: Are there disorders that women are more susceptible to? If so, which ones and why?

Microvascaular angina (chest pain caused by the small resistance coronary artery vessels that are

Asad U. Qamar, MD

FACC, FCCP, FSGC, FACP, FSCAI Cardiologist

not visible in a coronary angiography2) is more common in woman than men. Basically, the small arteries have the inability to dilate themselves and it is atypical angina but in the absence of any significant blockage in coronary arteries. Although incidence of diabetes is the same in women and men, women with diabetes do more poorly with CAD and PAD than men.

More important than symptoms, first of all woman should be aware of the fact that incidence of coronary and vascular disease is similar in woman and in men. Controlling lipids (cholesterol), diabetes, hypertension and smoking is important.

The symptoms to be aware of include shortness of breath on activity, indigestion, any back discomfort with activity (woman present more commonly with interscapular pain than men), numbness or tingling, and fatigue in the legs upon ambulation. Also, symptoms of palpitations, lightheadedness and dizziness are important for coronary artery disease and vascular disease in women.

We can do comprehensive cardiovascular evaluation focusing on risk factors and appropriate non-invasive imaging for early detection and treatment of coronary and vascular disease.

The onset of heart disease tends to appear in women later in life than males, and this can also be complicated or go undiagnosed due to the fact of other comorbidities that have developed. Women should begin educating themselves early and address the risk factors to help prevent and identify the risks related to cardiovascular disease.