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Category Archives: Cardiac Sciences

Heart attack symptoms in women: Are they different from those in men?

A heart attack is a serious health emergency that needs immediate medical attention. But, does it affect men and women differently?

Anatomically, hearts may look the same; however, there are important physiological differences between those of men and women. When a heart attack occurs, these distinctions affect the resultant symptoms as well. For instance, research suggests that during an attack, women are more likely to experience symptoms other than chest pain, such as pain in the neck, shortness of breath, dizziness, etc. However, chest pain remains one of the most widely reported symptoms of an attack.

Recognizing a heart attack

Heart attack symptoms depend on several factors and may show up differently based on gender, age, pre-existing conditions, etc. Some common early symptoms of heart attack are –

  • Mild chest pain
  • Pain in shoulders, neck, and jaw
  • Breathlessness
  • Anxiety
  • Sweating
  • Nausea
  • Fatigue

As per the Society of Cardiovascular Patient Care, 50% of all people experiencing a heart attack experience early heart attack symptoms. It’s important to be aware of these early symptoms to be able get quick  treatment to prevent heart damage.

Heart attacks symptoms in men

On an average, men have heart attacks earlier in life than women. If there is a family history of heart disease or an individual history of smoking, high blood pressure, obesity, etc., the chances of getting a heart attack are higher.

Some commonly reported symptoms of a heart attack in men are –

  • Standard pain in the chest, a feeling of “pressure” like something heavy sits on the chest, with a squeezing sensation
  • Irregular heartbeat
  • Shortness of breath
  • Pain or discomfort in the upper body – arms, back, neck, jaw
  • A feeling of dizziness or passing out
  • Breaking out in a cold sweat

For men, heart attack symptoms typically occur fast. Often, plaque build-up in the arteries leads to heart attacks; in men, the plaque suddenly ruptures, causing the body’s emergency response system to form a protective blood clot. This clot blocks arteries, causing a heart attack. What’s interesting is that, in men, such ruptures account for 75% of all heart attacks but, in women, only 55%. When this happens, the symptoms are obvious as opposed to women who show subtler signs of a heart attack.

Heart attacks symptoms in women

In recent years, scientists have discovered that heart attack symptoms can be different in women. Studies have found that the most frequently reported symptoms by don’t even include chest pain.

Common heart attack symptoms experienced by women are –

  • Sleep disturbances
  • Lightheadedness
  • Fatigue lasting for several days or sudden fatigue
  • Shortness of breath
  • Jaw pain
  • Indigestion
  • Pain in the upper back, shoulder, or throat
  • Pain in the center of the chest, sometimes spreading up the arms

Women have unique risk factors

Women develop conditions that men cannot – PCOS, endometriosis, etc., all of which can increase the chances of having a heart attack. In fact, a study concluded that women suffering from endometriosis were up to 3 times more likely to have a heart attack!

What’s more, women with common conditions like diabetes, high blood pressure, etc. are at greater risk for a heart attack than men with these conditions. In fact, it has been found that clinical depression, which is twice as common in women, actually doubles a woman’s risk of a heart attack. Unfortunately, many women’s symptoms go untreated, owing to a tendency to dismissing them and not seeing a doctor and putting families first. In fact, women’s symptoms are also often wrongly diagnosed.

It is known that women tend to have heart attacks later in life than. While the average age for a first heart attack in men is 65 in men, it is 72 in women. It is believed that women’s exposure to estrogen offers some extra protection against heart attacks, but only up until menopause. Once estrogen levels drop, this advantage goes away.

Women are less likely to survive heart attacks

According to studies, more women than men die due to heart attacks. This could be attributed to the fact that women take longer to visit the hospital, perhaps due to mild symptoms that don’t seem life-threatening. Because their heart attacks can be harder to diagnose, they’re also less likely to receive the right treatment.

Additionally, women receive less aggressive treatment after an attack. After surviving an attack, they are at greater risk for blood clots that can cause further heart attacks. However, they’re less likely to receive medication to prevent clots, which is why they are more likely to have a second attack within 12 months.

Prevent heart attacks with regular check-ups

Irrespective of your gender, you can take steps to reduce the risk of an attack. Get ample exercise, eat a nutritious, heart-healthy diet, maintain a healthy weight, and schedule regular check-ups to track blood pressure, cholesterol, and blood sugar levels. Even though women and men may experience different heart attack symptoms, they ought to take the same steps to prevent heart attacks and increase well-being.

Paediatric Cardiology

When we think of heart disease, we rarely ever picture young children suffering from the ailment. We think of cardiovascular diseases as something that builds up over time with smoking, a sedentary lifestyle, high cholesterol levels, etc. However, the truth is that heart disease and attacks can afflict anyone, including little kids and teenagers who may otherwise appear healthy.

Sometimes, heart problems in children are present from the birth, i.e. congenital. Often, heart issues will remain undetected until symptoms appear.

What is heart failure?

The term ‘heart failure’ is used to describe a heart that has ceased working properly. In adults, heart failure is often a result of high blood pressure, diabetes, smoking, coronary artery disease, etc. In infants, toddlers and teenagers, it happens for other reasons.

Children and teenagers can certainly experience heart failure, although it’s rare and often the result of a congenital heart defect.

Heart failure in children – Causes

For the growth and development of a child, the heart must maintain normal function and provide blood flow in the body. Sometimes, it does not function normally, a condition termed as ‘heart failure’. However, this doesn’t mean that the heart has altogether stopped working.

In children, there are two major causes of heart failure. The first is called over-circulation failure, which happens when, due to a congenital defect, blood mixes between the heart’s left and right chambers. Low blood (anaemia) can also cause an over-circulation failure.

The second is called pump failure, where the heart muscle is damaged and is not able to contract normally. This can be the result of a viral infection or defective coronary arteries that prevent effective blood flow to the heart muscle.

Sometimes, abnormal heart valves can also lead to heart failure; such valves do not close properly and cause blood to leak backwards. Some drugs like those used in cancer treatment may also damage the heart muscle. In some rare cases, children with muscular dystrophy develop problems with their heart muscle, which causes the hurt to become inefficient at pumping blood.

Risk factors for heart failure in children

Paediatric cardiologists note that risk factors for heart problems can start developing at a young age. Apart from genetics, one of the earliest risk factors is maternal smoking while the child is in utero.

Another risk factor is inadequate sleep. Children who don’t get enough sleep are more likely to have belly fat, high blood pressure, and an increased risk of diabetes. All of these can start a chain reaction leading up to heart failure.

Symptoms of heart failure in kids

Some common symptoms of heart disease that kids experience are –

  • Breathing difficulties
  • Low blood pressure
  • Poor growth
  • Excessive sweating
  • Respiratory infections
  • Pneumonia
  • Fatigue, especially after a viral infection

How is heart failure diagnosed?

Physicians typically use chest X-rays to determine damage to the heart. It is best to visit a paediatric heart specialist for proper evaluation and testing. Doctors may suggest some tests such as an electrocardiogram (EKG or ECG), ultrasound of the heart (echocardiogram), etc. None of these tests is painful. Sometimes, more detailed tests may be required, such as a heart catheterization study, where a small plastic tube (catheter) is placed inside the heart to record pressures and amount of oxygen in the heart.

How is heart failure treated?

If heart failure is a result of over-circulation due to a congenital defect, a surgery is often recommended. Medications such as diuretics and afterload reducers are prescribed to improve the heart’s pump function. Because over-circulation causes poor growth, doctors also recommend nutritional supplements to ensure the child’s growth.

If the heart condition is the result of a pump failure, similar medications are prescribed along with those for lowering blood pressure. Sometimes, a surgery is also required. When the heartbeat is too slow, a pacemaker is placed to maintain a normal heart rate. This needs a surgery.

In rare cases, when the pump failure is the result of irreversible muscle damage, medications don’t improve the heart function, which continues to worsen. In such a situation, a special pacemaker is required to improve the heart’s pump function. However, if the situation doesn’t improve, the doctor may suggest a heart transplant.

What should you do as a parent?

It’s important for parents to understand the causes, risk factors, and treatments of heart failure for children. At an early age, they must instil heart-healthy habits in children. Physical activity and good dietary habits should be encouraged.

Many paediatric cardiologists recommend breastfeeding infants, which has been found to lower a child’s risk of developing heart disease.

As parents, it is your responsibility to provide proper medical care if your child has suffered heart failure. With timely interventions and a healthy lifestyle, children with heart failure can lead healthy and active lives.

Open-Heart Surgery

In the term open-heart surgery, “open-heart” is can be misleading. Contrary to popular belief, the term “open” is used in reference to the chest, not the heart.

What is open-heart surgery?

Open-heart surgery is any kind of surgery in which, an incision is used to open the chest and perform surgery on the muscles, valves, or arteries of the heart.

Open-heart surgery is usually performed on people diagnosed with coronary heart disease. In a coronary disease, the blood vessels which supply blood and oxygen to the heart muscle can become narrow and hard – often referred to as “hardening of the arteries” – and may result in a heart attack.

Common types of open-heart surgery include:

  • Surgery to current heart defects present at birth
  • Heat bypass surgery
  • Heart valve surgery

However, many people remain misinformed about the specifics of open-heart surgery. Here are some of the most common myths about open-heart surgery you should not believe in.

Myth: The heart is taken out to perform the surgery

This is a common misconception that your heart is taken out of your chest, given the term “open-heart surgery”. In truth, only a heart transplant surgery requires the physical removal of your heart.

Besides, over the years, new heart procedures have been modified. Most heart surgeries can now be completed using smaller incisions and invasive techniques, instead of wide openings. As a result, there are fewer scars and quicker recovery.

Myth: Open-heart surgery is very risky

Every surgery involves its risks and complication. Likewise, open-heart surgery also presents the risk of complications, including general surgery risks and risks linked with anesthesia. The risk can vary from one open-heart surgery to another. Besides, the risks involved are higher if the blood is pumped by a cardiopulmonary bypass machine instead of the heart.

In truth, only the operating surgeons can determine the individual risk of complications from the open-heart surgery, based on factors such as:

  • Patient’s current health state
  • Procedure of the surgery
  • Patient’s age and gender

Moreover, the risk of complications is increased in patients over and above 70 years old, in patients who have undergone previous heart surgeries, and those with chronic conditions like:

  • Diabetes
  • High blood pressure
  • coronary artery disease

Myth: Open-heart surgery can affect the brain function

Earlier, stroke and brain damage were common occurrences after open-heart surgery. Luckily, those complications can now be averted easily. In recent years, targeted improvements in surgical techniques have reduced such risks to a great extent.

Nonetheless, other complications can arise owing to specific medical conditions. It is best to discuss them with your doctor before the operation. However, the risks of brain damage and stroke after open-heart surgery are lower than before.

Myth: Angioplasty is safer than open-heart surgery

In angioplasty, minimally invasive procedures are used to open the blocked arteries around the heart. Generally, a stent which is a tiny tube used to keep a blocked passageway open is used during the procedure to maintain the opening. A tiny inflated balloon is inserted into the vessel to help the blood to flow again. And then, the balloon is inflated to open the passageway.

Now, the recovery time for angioplasty is certainly quicker than open-heart surgery and requires smaller incisions, but angioplasty is not recommended for everyone with coronary heart disease. Besides, patients may need more procedures or another angioplasty after the initial surgery.

Myth: There are many physical restrictions after open-heart surgery

Typically, the patient spends the first night after the surgery in the intensive care unit (ICU). The patient is then shifted to the regular care room for the next three to seven days. At this point, he can resume light activities.

However, it may take up to six weeks for the patient to feel better and six months to make a full recovery. But in the long term, patients can benefit from the surgery if they improve their heart health. This can be achieved by:

  • not smoking
  • following an active lifestyle
  • avoiding foods rich in sugar, salt, and fat
  • controlling high BP and cholesterol

Myth: Robotic surgery is better

Firstly, let us understand what robotic surgery is.

Robotic surgery is a type of heart surgery performed by making small cuts using tiny instruments and tools controlled by robots. In this way, surgeons can perform surgery which is less invasive as compared to open-heart surgery.

Usually, robot surgery is used in different heart-related procedures such as:

  • coronary artery bypass
  • cardiac tissue ablation
  • tumor removal
  • heart defect repair
  • valve surgery

Robotic surgery can remove several complications involved in open-heart surgery. Nonetheless, there are many risks involved with robotic surgery as well, including stroke, infection, heart attack, and death. In fact, the surgeon may be unable to complete the robotic surgery in certain cases and may need to perform open-heart surgery.

As you can see, a lot of information surrounding open-heart surgery is false and misconstrued. Therefore, it is very important to separate fact from fiction before making any assumptions.

Cardiac Rehabilitation

Cardiac rehabilitation or cardiac rehab is highly effective in providing preventative care, advancing recovery, and preventing future cardiovascular disease in cardiac or heart patients. Cardiac rehab helps you return to optimal health and function following events like a heart attack or surgery.

As per World Health Organization (WHO), cardiac rehabilitation or rehab is: “ the sum of activity and interventions required to ensure the best possible physical, mental, and social conditions so that patients with chronic or post-acute cardiovascular disease may, by their own efforts, preserve or resume their proper place in society and lead an active life”.

Typically, a cardiac rehab program is an individually designed outpatient program of education, progressive exercise, emotional support, and risk modification – to improve the overall well-being of cardiac patients.

Generally, cardiac rehab is recommended to patients whose medical history includes:

  • Heart attack
  • Heart failure
  • Coronary heart or artery disease
  • Heart transplant
  • Lung transplant
  • Heart surgery (bypass, valve, or artery surgery)
  • Stroke or mini-stroke
  • Angina
  • Cardiomyopathy
  • Pulmonary hypertension

Procedure involved in a cardiac rehab program

A cardiac rehab program is a comprehensive program for secondary prevention care, aimed at early detection of the disease; and reducing its progression via healthcare interventions from your healthcare professionals including physical therapists, cardiologists, nutrition specialists, mental health specialists, and more.

The healthcare interventions can include management of psychological, nutritional, behavioral, social, and other risk factors that can affect patient outcomes – changes resulting from health care – to promote a healthier lifestyle and reduce the future occurrence of cardiovascular events.

Primarily, there are three phases involved in a cardiac rehab program.

Phase I: Inpatient Phase

The first phase of cardiac rehab is initiated right after your cardiovascular event. The inpatient phase typically involves early progressive mobilization to restore mobility; making sure the patient can perform self-care and simple household tasks post-discharge.

In addition, cardiovascular patients are informed about the nature of illness and essential treatment, address the risk factors, prescribe appropriate assistance devices such as cane or walker, and follow-up planning.

Phase II: Supervised Outpatient Program

Once you are discharged, your cardiac rehab treatment becomes a supervised outpatient program, usually lasting from about three to six weeks, often involving lessons about –

  • reducing aggressive risk factors
  • self-monitoring your cardiac responses to specific exercises
  • appropriate exercise routines
  • self-monitoring your heart rate and symptomatic response to exercise

Moreover, you will closely work with a physical therapist during this phase, to improve your exercise tolerance and monitor any negative responses. This phase mostly focuses on your safe return to functional mobility. By the end, you will be able to perform more independent activities and exercises.

As the outpatient program advances and you become more independent, your physical therapist can create a cardiac rehab program tailored to your special needs. Generally, the program includes suitable exercises involving strengthening, flexibility, and aerobic exercises.

Phase III: Lifetime Maintenance

In the final phase of the cardiac rehab program, independent and ongoing conditioning is emphasized. The primary goal of the lifetime maintenance phase is to focus on physical fitness and reducing additional risk factors via home or gym-based exercises.

In addition, emphasis is given to risk modification and exercises learned during the second phase of the cardiac rehab program. Once the three phases are over, you should have a complete knowledge of your cardiac condition, risk factors, and ways to maintain optimal health.

Besides, your cardiac rehab program is tailored to meet your special requirements, from medicine education, exercises, diet to other support. By following independent exercise and conditioning, you can facilitate long term lifestyle changes and keep the risks of cardiac problems at bay.

Risks factors

Not all heart patients can undergo a cardiac rehab program. At the start of a cardiac rehab program, your healthcare team performs a complete physical and mental assessment to establish a risk profile. Generally, the assessment is used to set goals for your cardiac rehab program and facilitate care with minimal risk involved.

Overall, cardiac rehab is safe with very low risks of major cardiovascular complications like death, heart attack, cardiac arrest, or other serious injuries. Nonetheless, on rare occasions, some patients can suffer minor injuries like strained muscles or sprains while exercising.

After cardiac rehab

After completing your cardiac rehab, you need to follow the heart-healthy habits and skills you developed during the program, for the rest of your life. Consequently, you can rebuild your life both physically and emotionally, and return to an active lifestyle.

Through a cardiac rehab program, you can benefit from:

  • Mortality reduction
  • Enhanced exercise tolerance
  • Symptom relief
  • Diabetes control
  • Nutritional counseling
  • Smoking/tobacco cessation
  • Stress management
  • Medicine management
  • Weight management

Cardiac rehab has been highly effective in improving cardiovascular patients’ overall quality of life and preventing the risk of future cardiovascular events. Nonetheless, to make the most of your cardiac rehab program, make sure to follow the exercise routine and lifestyle changes lifelong.

Myths and facts about women and heart disease

Heart disease is one of the leading causes of death among women. Unfortunately, many women remain unaware of its prevalence, risk factors, and treatment. What’s more, many dangerous misconceptions float, putting women’s lives at risk.

Many women have some risk factor – diabetes, smoking, obesity, smoking, high cholesterol, high blood pressure – but remain misinformed of their odds of contracting heart disease and its dangers. The truth is, heart disease spares no one. Because your health is a non-negotiable, it can literally save your life to stay aware of the facts surrounding heart attacks. Let us look at some common myths and facts surrounding this killer disease.

Myth: Heart disease only affects women after menopause

Fact: It is true that estrogen and progesterone offer some protection against the disease, an advantage that starts to wane off around menopause. However, women of all ages can be at risk for developing this condition, despite menopausal women being at a higher risk. Fortunately, women can increase their awareness surrounding heart problems during the time of pregnancy. Women that develop conditions such as gestational diabetes that raise their risk for heart disease can proactively make lifestyle changes to prevent the condition. Additionally, women should also see a doctor at the time of menopause and discuss the risks. To stay completely safe and identify issues early on, have regular blood pressure, cholesterol, and BMI checks, irrespective of your age.

Myth: Heart attack symptoms are common for women and men

Fact: While classic attack symptoms like chest, arm, jaw pain are common in both men and women, other subtler signs like fatigue and breathlessness are more likely to occur in women. Many women are known to die suddenly of heart disease without showing any symptoms!

Women tend to have milder symptoms such as:

  • Nausea and vomiting
  • Fatigue or weakness
  • Sudden dizziness
  • Tightness in the chest
  • Shortness of breath
  • Sleep disturbances

In fact, researchers have found that women often ascribe these symptoms to causes like their age and busy work schedules, thus not seeking treatment for a heart blockage and assuming the cause less serious.

If you are experiencing an unusual change in yourself, and feel a lack of energy or breath, it could point to heart trouble. If you notice any strange symptoms, schedule a check-up immediately.

Myth: Only men have to worry about heart disease

Fact: It is true that gender differences have a role to play in heart disease. Female hormones also protect women from heart disease to some extent, but this protection decreases around menopause.

While is it true that more men die of heart disease, their death rate has steadily declined during the past couple of decades. Thus, women should look out as much and stay aware of the risk factors for developing this condition.

Myth: Heart disease does not affect active women

Fact: Even if you religiously work out every day, your risk for heart disease isn’t eliminated. Other factors like cholesterol, smoking, family history, diet, etc. can counterbalance the positive effects of exercise. Despite being thin, some women may have high cholesterol. Thus, exercise reduces the risk of heart disease but does not make women risk-free. You can lower your risk of heart disease by having plenty of heart-healthy foods and maintaining a healthy weight.

Myth: If you do not have a family history, you do not have to worry about it

Fact: Even without a family history, many women have heart issues. While a family history is a risk factor, so are others – smoking, obesity, high blood pressure, high cholesterol, physical inactivity, etc. Moreover, some conditions that only or primarily affect women can also contribute – menopause, gestational diabetes, autoimmune diseases such as lupus, etc.

Myth: If you have a family history, you will get heart disease

Fact: Fortunately, this is a myth, despite women with family history being at a higher risk. If you are aware of the risk factors and lead a healthy lifestyle involving proper diet and exercise, you can reduce your risk of getting a heart attack, despite having a family history.

Myth: Women are more likely to survive heart attacks

Fact: Heart attacks are not always fatal. However, it is proven that young women are more likely to die than men are after a heart attack. One big reason is that women are less likely to receive proper post-attack treatment to prevent further attacks. If you have experienced a heart attack, discuss proper follow-up care with your doctor.

The more you know about your heart and its workings, the better you can take care of it. Irrespective of your age, look out for warning signs of heart trouble. More importantly, lead an active and healthy lifestyle to reduce the effect of risk factors, if you happen to have any.

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