As part of your treatment, you'll need to pay close attention to your symptoms, because heart failure can worsen suddenly. Your provider may suggest a cardiac rehabilitation program to help you learn how to manage your condition.
Women Get Worse Care For Heart Attack
Such inherent bias may manifest in the underuse of screening for CVD risk, as was found in a large study of Australian general practice in which the adjusted odds of a woman being screened for CVD risk factors were 12% lower than for a man [11]. In secondary prevention, Zhao et al. (2017) presented results from patients with a history of CHD recruited from routine outpatient cardiology clinics in 11 countries across Europe, Asia and the Middle East [12]. After adjusting for age, they compared the achievement of CVD risk factor and lifestyle targets between the sexes and found that women did worse than men in achieving guideline-based targets for high-density lipoprotein cholesterol, low-density cholesterol, total cholesterol, glucose, physical activity, obesity and cardiac rehabilitation. Men did worse only for blood pressure control and for achieving the target of not smoking (however, to put the latter result in context, female smoking is unusual in Asian and middle-eastern countries). Overall, only 8% of men reached all treatment targets, but the percentage was even lower for women, at 6%; lifestyle targets were more often met but, still, were achieved by relatively few people: 34% of men and 32% of women. Although individual patients have a great deal of responsibility for their own health behaviour, it is reasonable to conclude that there is more that their carers can do to improve risk factor awareness and action, both overall and in relation to sex disparities.
For those who survive a MI and leave hospital, women tend to have worse survival and be more likely to have a recurrent event. Figure 5 shows an example, although, in this case, sex differences disappeared after adjusting for age [16]. This is explained by women being generally older when they suffer MI, which shows the importance of controlling for age in such sex comparisons. All the same, given the female advantage in age-specific CHD rates before a CHD event, similar age-adjusted survival after an MI suggests that women have lost some of their natural advantage, which might be explained by women receiving worse secondary prevention care, as discussed above.
The greatest weight of evidence of a female disadvantage is for diabetes [34]. According to the above meta-analyses, having this risk factor more than doubles the risk of CHD but confers an additional 44% risk to women compared to men (see Figure 6). Results for stroke are similar but somewhat less extreme: the excess female risk is 27% (see Figure 7). This could be caused by relatively worse care to prevent the sequelae of diabetes received by women compared to men [35] and by women tending to have greater adiposity when diagnosed as positive for diabetes [36,37].
Heart failure is a chronic condition that gets worse with time. There are four heart failure stages (Stages A, B, C and D). They range from having a high risk of developing heart failure to having advanced heart failure.
Your treatment will depend on the type of heart failure you have and, in part, what caused it. Medications and lifestyle changes are part of every heart failure treatment plan. Your healthcare provider will talk to you about the best treatment plan for you.
A heart attack occurs when an artery supplying the heart with blood and oxygen becomes blocked. Fatty deposits build up over time, forming plaques in the heart's arteries. If a plaque ruptures, a blood clot can form and block the arteries, causing a heart attack. During a heart attack, tissue in the heart muscle dies due to lack of blood flow through the heart's arteries.
If your chest pain lasts longer than a few minutes and doesn't go away when you rest or take your angina medications, it may be a sign you're having a heart attack. Call 911 or emergency medical help. Only drive yourself to the hospital if there is no other transportation option.
If chest discomfort is a new symptom for you, it's important to see your health care provider to determine the cause and to get proper treatment. If you've been diagnosed with stable angina and it gets worse or changes, seek medical help immediately.
Chest pain is often associated with heart disease. But many people with heart disease say they have a mild discomfort that they wouldn't really call pain. Chest discomfort due to a heart attack or another heart problem may feel like:
If you have new or unexplained chest pain or think you're having a heart attack, call 911 or emergency medical help immediately. Don't ignore the symptoms of a heart attack. If you can't get an ambulance or emergency vehicle to come to you, have a neighbor or a friend drive you to the nearest hospital. Drive yourself only if you have no other option.
Risk factors are conditions or habits that make a person more likely to develop a disease. They can also increase the chances that an existing disease will get worse. Many of the risk factors that affect men also affect women. Important risk factors for heart disease are:
Many people with angina have a good quality of life and continue as usual. Living an active lifestyle is also really important to help stop your underlying coronary heart disease from getting worse.
Your doctor or nurse can tell you if you need to make any changes to your routine and make specific lifestyle changes.
This booklet is for people with angina, and for their friends and family. It explains what angina is, what causes it, how angina is diagnosed, and what can be done to treat the condition. It also explains what to do if you experience angina, or if you think you may be having a heart attack.
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Elena keeps an eye on her husband Frank to make sure he is taking care of his heart. But, she was surprised at a recent medical appointment when Dr. Reyes asked about her own family's history of heart disease. When Dr. Reyes heard that Elena's mother had died at age 58 after a heart attack, she told Elena that she, too, should be following a heart-healthy lifestyle. She said older women, as well as older men, can have heart problems. So now, Elena and Frank are both taking steps toward heart health.
People age 65 and older are much more likely than younger people to suffer a heart attack, to have a stroke, or to develop coronary heart disease (commonly called heart disease) and heart failure. Heart disease is also a major cause of disability, limiting the activity and eroding the quality of life of millions of older people.
High blood pressure and other risk factors, including advancing age, increase the risk of developing atherosclerosis (ath-uh-roh-skluh-roh-sis). Because there are several modifiable risk factors for atherosclerosis, it is not necessarily a normal part of aging. Plaque builds up inside the walls of your arteries and, over time, hardens and narrows your arteries, which limits the flow of oxygen-rich blood to your organs and other parts of your body. Oxygen and blood nutrients are supplied to the heart muscle through the coronary arteries. Heart disease develops when plaque builds up in the coronary arteries, reducing blood flow to your heart muscle. Over time, the heart muscle can become weakened and/or damaged, resulting in heart failure. Heart damage can be caused by heart attacks, long-standing hypertension and diabetes, and chronic heavy alcohol use.
Heart disease is caused by atherosclerosis (ath-uh-roh-skluh-roh-sis), which is the buildup of fatty deposits, or plaques, in the walls of the coronary arteries over many years. The coronary arteries surround the outside of the heart and supply blood nutrients and oxygen to the heart muscle. When plaque builds up inside the arteries, there is less space for blood to flow normally and deliver oxygen to the heart. If the flow of blood to your heart is reduced by plaque buildup or is blocked if a plaque suddenly ruptures, it can cause angina (chest pain or discomfort) or a heart attack. When the heart muscle does not get enough oxygen and blood nutrients, the heart muscle cells will die (heart attack) and weaken the heart, diminishing its ability to pump blood to the rest of the body.
They are described as "silent" because when they occur, their symptoms lack the intensity of a classic heart attack, such as extreme chest pain and pressure; stabbing pain in the arm, neck, or jaw; sudden shortness of breath; sweating, and dizziness.
Also, the location of pain is sometimes misunderstood. With SMI, you may feel discomfort in the center of the chest and not a sharp pain on the left side of the chest, which many people associate with a heart attack. "People can even feel completely normal during an SMI and afterward, too, which further adds to the chance of missing the warning signs," says Dr. Plutzky.
After 10 years, 8% had myocardial scars, which are evidence of a heart attack. Most surprising was that 80% of these people were unaware of their condition. Overall, the prevalence of myocardial scars was five times higher in men than in women.
SMI and regular heart attacks share the same risk factors: smoking, being overweight, lack of exercise, high blood pressure, high cholesterol levels, and diabetes. They can be just as dangerous, too. "SMI often leaves scarring and damage to the heart, which, combined with the fact that many people who have an SMI don't seek immediate care, can further raise a person's risk of a second and potentially more harmful heart attack," says Dr. Plutzky. In fact, people who have an SMI and don't get treatment have a three times greater risk of dying from coronary artery disease. "A silent heart attack is a loud signal your body sends that you have some kind of underlying health issue that needs attention," says Dr. Plutzky.
SMI is usually detected from an electrocardiogram (EKG) or echocardiogram, which can highlight heart muscle damage. Another method is a blood test for the molecular footprints of troponin T, a protein released by injured heart cells. That test is often used in emergency departments for patients with heart attack symptoms.
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