Symptoms, Diagnosis & Treatment For Coronary Artery Disease In Women

Submitted by Nic on December 6, 2012

Coronary heart disease is a health condition that occurs when there is a gradual buildup of plaque in coronary arteries especially in the inner walls. These arteries perform the important function of supplying blood and oxygen to the heart. Gradually, these plaque deposits can grow large enough to narrow the arteries and decrease the flow of blood to the heart. At times, these plaques can also rupture, lead to the formation of a blood clot, block the flow of blood and result in a heart attack.

Coronary artery disease in women happens to be the number one cause of death in the female population across the US. Most of us usually associate heart problems with men, but the truth is that more women die of heart conditions every year. On average, women who develop coronary artery disease are approximately 10 years older than men who get the same problem. With timely treatment, the outcome of this disease is the same in both the genders. However, in the past it has become quite clear that coronary artery disease in women is different from coronary artery disease in men.

There are three aspects of this disease that can be particularly problematic when it occurs in women. These aspects include -

  • The standard methods of diagnosing the disease in women can be a bit misleading
  • The disease is atypical
  • The symptoms of coronary artery disease in women are different

Unfortunately, most women develop an "atypical" form of coronary artery disease, which makes it difficult to recognize and diagnose the condition. The atypical patterns of coronary artery disease usually result in -

  • Missed diagnosis
  • Inadequate therapy
  • Worse outcomes

To avoid the problems mentioned above, it is important for you to first realize that women too can develop heart diseases. Also make it a point to undergo regular checkups so that the disease can be detected in the early stages.

Symptoms

When men suffer a heart attack they generally experience severe pain, pressure or discomfort in the chest and left arm. In women, this discomfort need not be severe or even the most prominent symptom. Some of the atypical symptoms of coronary artery disease in women include -

  • Discomfort in the form of a hot, burning sensation in the back, shoulders and arms
  • Tenderness in the neck and jaw area
  • Nausea and in some cases, vomiting
  • Shortness of breath
  • Perspiring
  • Dizziness or lightheadedness
  • Unusual fatigue

The symptoms of coronary artery disease in women are often mistaken for gastrointestinal disturbances or musculoskeletal pain because they are a lot more subtle as compared to crushing pain in the chest. This could be the case because women are likely to have blockages not just in their main arteries, but also in the small arteries that supply blood to the heart. These are called atypical symptoms, since they are not usually associated with a heart attack.

It is absolutely essential for you to call for emergency medical help without any delay in case you notice any of the signs and symptoms mentioned above. Take help and avoid driving alone to the emergency room, unless there is no other option.

Diagnosis

The diagnosis of coronary artery disease in women can be a bit of a challenge because the tests that usually work well in men can be misleading when conducted on women.

Problems generally occur with the Stress Test (only in women). During exercise, the electrocardiogram shows changes suggesting coronary artery diseases, even when the woman does not have the condition. To improve diagnostic accuracy, doctors may routinely add an echocardiogram or a thallium study while carrying out the stress test in the woman.

The most effective diagnostic test for typical coronary artery disease in women is the coronary angiography, as it helps identify the exact location of the blockages or plaques. However, if the woman is suffering from atypical coronary artery disease, this procedure can appear misleadingly normal.

Treatment

The management of coronary heart disease in women requires a combination of drug therapy, regular exercise, stress control and dietary modification. However, you may need to undergo a medical surgery or other types of therapy too.

Drug therapy

Your doctor may prescribe certain drugs in order to reduce symptoms, improve heart functioning and lower the risks of heart-related complications. Drugs that are prescribed for this purpose include -

  • Angiotensin-Covering Enzymes (ACE) inhibitors
  • Angiotensin receptor blockers (ARBs)
  • Anti-platelet medicines
  • Beta blockers
  • Calcium channel blockers
  • Nitroglycerine
  • Statins

Surgery

To treat the narrowing in your heart, your doctor may need to perform a surgical procedure, such as -

  • Coronary Artery Bypass Graft (CABG)
  • Angioplasty
  • Off Pump Coronary Artery Bypass (OPCAB)
  • Minimally Invasive Direct Coronary Artery Bypass (MIDCAB)

Lifestyle changes

Fortunately, you can keep the health of your heart from getting worse by following a few simple steps, some of which include -

  • Eating a diet that limits your intake of saturated fat and cholesterol
  • Exercising each day, for at least 30 to 60 minutes
  • Maintaining a healthy body weight
  • Quitting unhealthy habits like drinking excess alcohol and smoking
  • Reducing stress, but practicing yoga, deep breathing or meditation
  • Taking medication as prescribed by the doctor

Coronary artery disease is a very serious condition, which can result in a heart attack or even death. Therefore, it is absolutely essential for you to consult a doctor if you suspect that you have this condition, or if you are at a high risk.

References

  • Christophe Tribouilloy, Marcel Peltier, Michele Senni, Laurent Colas, Jean-Luc Rey, Jean-Philippe Lesbre, Multiplane transoesophageal echocardiographic detection of thoracic aortic plaque is a marker for coronary artery disease in women, International Journal of Cardiology, Volume 61, Issue 3, 10 October 1997, Pages 269-275, ISSN 0167-5273, 10.1016/S0167-5273(97)00162-9.
  • Marian Limacher, Eileen Handberg, Evaluating women with chest pain for the diagnosis of coronary artery disease, Disease-a-Month, Volume 48, Issue 10, October 2002, Pages 647-658, ISSN 0011-5029, 10.1016/S0011-5029(02)90009-X.
  • Hallveig Broddadottir, Louise Jensen, Colleen Norris, Michelle Graham, Health-related quality of life in women with coronary artery disease, European Journal of Cardiovascular Nursing, Volume 8, Issue 1, March 2009, Pages 18-25, ISSN 1474-5151, 10.1016/j.ejcnurse.2008.05.002.
  • Dong-Feng Yeih, Por-Jau Huang, Yi-Lwun Ho, Enhanced Diagnosis of Coronary Artery Disease in Women by Dobutamine Thallium-201 ST-Segment/Heart Rate Slope and Thallium-201 Myocardial SPECT, Journal of the Formosan Medical Association, Volume 106, Issue 10, October 2007, Pages 832-839, ISSN 0929-6646, 10.1016/S0929-6646(08)60048-0.
  • C. Leuzzi, M.G. Modena, Coronary artery disease: Clinical presentation, diagnosis and prognosis in women, Nutrition, Metabolism and Cardiovascular Diseases, Volume 20, Issue 6, July 2010, Pages 426-435, ISSN 0939-4753, 10.1016/j.numecd.2010.02.013.
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