Most Women Struggle to be Taken Seriously

When we think of heart disease, we often picture a man grabbing his chest in pain from a heart attack. But there’s a lot more going on in the body for years (even decades) beforehand that led up to that point.

Let’s start with the definition. Heart disease is also known as cardiovascular disease. The cardio refers to the heart itself and vascular is for vessels like arteries and veins that run throughout the whole body. So, heart (or cardiovascular) disease refers to medical conditions that affect the heart and vessels. There are many different medical conditions including:

Coronary artery disease (or CAD) is known to be caused by atherosclerosis (a buildup of plaque inside the walls of the arteries). This accumulation narrows the vessels that supply blood and oxygen to the heart. In women, CAD might happen even without severe plaque buildup. Women are more likely to have unusual ways of developing CAD. Compared to men, women with heart attacks usually have less plaque in their arteries to explain the cause of the obstruction of blood flow to the heart muscle. When plaques form on the walls of the arteries, it also causes inflammation. Plaque formation is encouraged in several ways:

High blood pressure (hypertension) is also known as the silent killer because it has no symptoms and often goes undiagnosed; it is a huge contributor to heart disease deaths. In 2013, more than 360,000 American deaths were from high blood pressure.

Hypertension is very common in industrialized nations. More than 20% of the general population has hypertension and many don’t even know it. High blood pressure increases greatly with age, affecting only 5.9% of women between the ages of 18-44. However, that number rises to 39.1% for women between the ages of 45-64. For women who are 65 or older, nearly three out of four (or 74.4%) have high blood pressure.

High blood pressure also varies by race and ethnicity. A 2009-2010 study showed that over 40% of African-American women had hypertension, compared to about 25% of Caucasian and Hispanic women. However, 44.8% of women studied with uncontrolled hypertension reported that they had never received a diagnosis from a doctor.

High blood pressure increases your risk for dangerous health conditions, such as:

When your blood pressure is high, your blood vessels lose elasticity and become stiffer and less flexible, leading to heart disease. This results in damage to the vessels. How this injury happens is not very well understood.

This injury causes plaque formation in specific areas of the blood vessels, not throughout their whole length. The majority of the plaque buildup appears to happen around areas where the artery twists or branches. This is believed to occur as a reaction to unstable blood flow due to blood pressure. If the blood flow is altered there is an increase in the pulsing of the blood flow and the pressure is increased. This pressure between circulating blood and the lining of the vessel finally results in the lining becoming disrupted (the injury) and plaque starting to build up.

Another mechanism through which high blood pressure may be involved in heart attacks is through rupture of the plaque. When a plaque builds up inside a vessel, and that vessel has high pressure inside it, pieces of that plaque can break off, or rupture. The rupture of the plaque causes the blood inside that vessel to clot because the body treats this rupture like an injury. This is similar to the clot (scab) that forms when you cut your skin. Because this is happening inside a small vessel, the clot grows and blocks the flow of blood through that vessel. This can result in a heart attack.

When your blood pressure is high, your heart works harder, causing it more stress. In addition, high blood pressure will initially make your heart muscle get thicker as any muscle will do when it is working against high resistance. Take a look at somebody that lifts heavy weights regularly, their muscles are bigger. However, if the high blood pressure is not controlled, the heart will eventually get weak through remodeling of the muscle that grows without appropriate blood flowing to that area.

In general, many symptoms of heart attacks in women are referred to as atypical symptoms. There is nothing atypical about women’s heart attack symptoms other than they are not the symptoms that are typically experienced by men. It’s time that we recognize the differences between women’s and men’s heart health. Women and men with CAD experience different symptoms and are often treated differently and have different outcomes.

Women should look for symptoms of:

As you can see, the most common symptoms of CAD in women can be very subtle and can create a confusing picture, which may delay an accurate diagnosis. For many women, this results in many and repeated non-heart-related tests before getting to a definitive diagnosis. This can bring along with it increased worry, sadness and frustration.

You have to be your own advocate! Unless you are paying attention to your symptoms and insist on getting a medical examination, your heart condition can go undiagnosed and, in the worst-case scenario, result in a heart attack.

If you are experiencing any of the symptoms mentioned above, don’t hesitate to seek medical attention. If you feel you are not being taken seriously, find another doctor.

Despite the efforts to improve diagnosis and treatment of heart disease in women, we still encounter significant gaps in understanding how the disease starts and progresses, and how to best treat it. As a specialist in the management of heart disease, I believe in working to develop the best tools to be able to identify it, before it becomes a life-threatening problem. My philosophy is early intervention. Early intervention will always be better than treatment.

Heels vs Ties is my initial written effort to spread the word to all women. It is up to us how medical care is going to change in the future. Once you are able to recognize your risk factors and symptoms, you can become your own advocate. On that day, you will be working together with many other women in closing the gender gap.

Every woman’s life matters. Some doctors are not aware of the differences, they are not aware of disparities in the care delivered to women (heels) vs. men (ties); or even of the different signs and symptoms of heart disease in women.

With this website I intend to empower you, your daughters, mother, cousins, aunts, neighbors, and friends to take charge of your health and choose life. A healthy life. And I hope it will help you prevent the stent.