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Nitza I. Alvarez, MD

How do I know if my heart is healthy?

Women, ask yourself: How do I know if my heart is healthy?
As a woman and a cardiologist, here is what you need to know, even if you have no symptoms

You’ve heard stories of very healthy people who ate right and exercised, yet they had a heart attack. This is not as uncommon as you might think. Do you know how many women die suddenly of heart disease without experiencing any symptoms at all? Sixty-four percent! Yes, more than half of the women who die suddenly from heart disease had no idea that they were at risk.
I don’t want you to be a statistic. You need to know if that could be you. What if you have no symptoms? What if you eat healthy and exercise? What do you and your doctor need to do? Here’s how to know if your heart is healthy—especially if you’re a woman.

Heart health for women

If you have symptoms, you know you should talk to a doctor about them. But, what if you don’t have any symptoms? As a cardiologist specializing in women’s heart health, I like to say “You don’t know until you know.” Even if you think you’re doing everything right and your heart is okay, you should take these steps to be sure.

My recommendation to all women is—even if you have no symptoms—you should get a good, in-depth cardiac health evaluation. This includes tests to be sure that your heart is healthy and you’re not unknowingly at risk. Many women end up having a heart attack or dying from heart disease because nobody completed a good evaluation to let them know if their heart is healthy.

How to know if your heart is healthy

The standard methods for assessing risk for heart disease have not been as effective for women as they have for men. We know that sixty-four percent of women who die suddenly from heart disease had no symptoms. This tells us that traditional risk factors underestimate the true risk for women.

The first thing you can do is see your doctor. She will probably start by asking you about your medical and family history and do a physical exam. During this appointment, be sure to ask your doctor all of your health questions. Check out our blog post here.

Your doctor may then recommend some tests. She should know that the tests used to diagnose heart disease are less accurate in women than they are in men. For example, tests used to detect plaque buildup in the coronary arteries (the ones that supply your heart muscle with oxygen and nutrients) are less accurate in women. That’s because women are less likely to have obstructions in these essential arteries than men are.

This is why it’s very important to see a doctor who knows women’s health and can do an in-depth evaluation. Here are three tests that your doctor may recommend to see if your heart is healthy.

Heart test 1.

The stress test

A standard stress test is used to find out if you have a blocked coronary artery. To do it, you are asked to ride a stationary bike or walk on a treadmill. These exercises are used to “stress” your heart. While you’re doing that, your doctor monitors your blood pressure, heart rate, and your heart’s electrical activity. If these results are abnormal, your doctor may order further tests. The great news is that there is a new type of stress test that appears to be more effective at diagnosing heart disease in women. This is called the Cardiac MRI stress T1 test. You can ask your doctor about this type of stress test.

Heart test 2 .

The CT calcium score test

A CT calcium score test is one I like to call the “mammogram of the heart.” It measures how much calcium buildup is in your coronary arteries. For more information on this test, see why every woman needs a CT calcium score test for her heart. Read more about this screening test here

Heart test 3.

The heart (or coronary) catheterization

The most common type of heart catheterization is an angiogram. These tests use x-rays and a dye to find restrictions in blood flow to the muscle of the heart. If a restriction is found, a doctor can do an angioplasty right then and there to open the clogged arteries. Angioplasties use a small balloon to open the artery so the doctor can insert a small cylinder called a stent. The stent will keep the blocked artery open so your heart muscle can be healthier.


Having no symptoms of heart disease does not guarantee that your heart is healthy. Eating well and exercising are very important for heart health, but there may still be an underlying issue that you don’t know about. You may feel okay and think you’re okay, even if you may not be.

If you want to know if your heart is healthy you need a good examination from a doctor who knows women’s heart health. It is always a smart idea to do an in-depth cardiac evaluation along with your physical exam. These will tell you whether you need tests to detect unknown heart disease risk. Tests may include a stress test, CT calcium score test, and/or a heart catheterization. And, as a woman, it’s especially important to speak with a doctor who knows how women’s heart health is evaluated differently from men’s.

Remember, “You don’t know until you know.”

Make your appointment today.


Alvarez, N. 2019. Heels vs. Ties: Living with your #1 threat. RI-AL Consulting.

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