Sep. 12--Does the world need another book about heart disease and cardiac care?
Perhaps the world doesn't, but women do.
For decades, scientists and clinicians considered the female heart to be a smaller duplicate of a male heart. Recent findings have banished that paradigm, and researchers are finding significant differences between the hearts of males and females. These differences also affect the symptoms and treatment of heart attack and other cardiac disorders in women.
About 44 million women have, or are at risk for, heart disease, according to the National Coalition for Women with Heart Disease.
"We've neglected women's hearts," said Dr. John A. Elefteriades, chief of cardiothoracic surgery at Yale-New Haven Hospital and author of the just published "The Woman's Heart, An Owners Guide," from Prometheus Books.
Dr. Teresa Caulin-Glaser, director of preventive cardiology and research at Ohio State University, coauthored the book.
The 304-page book covers the risk of heart disease in different phases of a woman's life; diseases women may encounter; pregnancy and heart disease; surgery, genetics, and how the risk of heart disease rises after menopause.
Compensating for overall average differences in size, women's hearts are smaller, and their coronary arteries are narrower, Elefteriades said.
Research also suggests women's hearts are linked emotionally to their brains. Men's feelings affect their hearts, but women occasionally show "broken heart syndrome" after experiencing the end of a marriage, death of a loved one or another trauma, he said.
"Women go to the emergency room and it looks like they're having a heart attack," Elefteriades said. But instead of finding plaque and clogs, the women's coronary arteries are clear, he said. After a few days of support, the women are back to good health. Without care, however, broken heart syndrome can lead to shock and then death.
Broken heart syndrome is rare, Elefteriades said. Heart disease may contribute to depression and vice versa.
Otherwise, women's hormones tend to protect them against atherosclerosis. "There is almost none in pre-menopausal women," he said.
The continually changing and complicated hormonal milieu of women changes the way their hearts act and behave, Elefteriades said.
For example, women often do not have the same heart attack symptoms as men. Often, women having heart attacks complain of "not feeling right," or of pain in the back, shoulder or jaw. "Their presentation is different," he said.
Some women continue to believe hormone replacement therapy is cardio-protective. "This is not true," Elefteriades said. "The bulk of evidence is that hormones given to postmenopausal women is not protective of the heart. But, the increased danger is very small, so very, very bad menopausal symptoms can be treated with hormone replacement therapy."
Other misunderstandings are equally common, he said.
For instance, many believe breast cancer is the leading killer of women. "I don't mean to minimize breast cancer, but it is dwarfed by heart disease," Elefteriades said. "Women's deaths from heart disease are tenfold higher."
Another "myth" is that more men die of heart disease than women. "This is not true," Elefteriades said. "After age 70 to 75, more women die from heart disease than men. Women's heart disease is delayed by 12 to 15 years compared to men," he said.
To promote heart health, Elefteriades said the best strategies are to keep weight down, exercise and monitor and treat high cholesterol. To see more of New Haven Register, or to subscribe to the newspaper, go to http://www.nhregister.com. Copyright (c) 2008, New Haven Register, Conn. Distributed by McClatchy-Tribune Information Services. For reprints, email tmsreprints@permissionsgroup.com, call 800-374-7985 or 847-635-6550, send a fax to 847-635-6968, or write to The Permissions Group Inc., 1247 Milwaukee Ave., Suite 303, Glenview, IL 60025, USA.
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