With Cardiologist Chippy Ajithan, MD
Did you know that heart disease is the leading cause of death for women in the United States?
According to the American Heart Association, cardiovascular disease causes 1 in 3 deaths among women each year; that’s approximately 1 woman every minute.
For a closer look at heart disease in women, we talked with Sarasota Memorial staff cardiologist Chippy Ajithan, MD, FACC. Board certified in Internal Medicine and in cardiovascular disease, Dr. Ajithan specializes in non-invasive cardiology and has a passion for women’s heart health. Here, she addresses heart attack symptoms, how to live a heart-healthy lifestyle, and ways to reverse a family history of cardiovascular disease.
Are women's heart attack symptoms different than men's?
Women actually present with heart attack symptoms very similar to men. Women complain of chest tightness, pressure, pain. We can have discomfort in the arms. We can have the discomfort radiate into our neck, our jaw, our back.
But women also tend to have more “silent” heart attacks than men, experiencing few symptoms or symptoms not commonly associated with heart attacks. Women are more likely to feel nausea, vomiting or belly pain; upper back pain that travels into the jaw; or extreme fatigue. They may feel like they're having the flu or significant indigestion. Symptoms may be mild to start but get worse over time. Women can also present with symptoms at rest, during sleep, or symptoms prompted by mental stress more so than a male counterpart.
Should I take aspirin if I think I'm having a heart attack?
Absolutely. Take an adult dose aspirin, 325 milligrams, and chew it for 30 seconds, then swallow. What this does is cause the white clot of an acute heart attack to start to ease up. A heart attack involves a mix of red clot and white clot, and you want to inactivate that white clot, called “platelets.” The fastest way to do that is to chew an aspirin.
Some people also think they could take Alka-Seltzer instead, because it contains aspirin, but chewing a full-strength, non-coated adult aspirin is the best thing you can take when you think you might be having a heart attack. Don't just swallow it with water, and sure it’s not coated; coating reduces the availability of the drug to the body, so choose non-coated if you can.
Are there any female specific disorders that increase a woman's risk of heart disease?
Yes, there are specific conditions that affect women much more than men.
We’re finding that the traditional risk factors that cause people to have heart disease may have a greater importance in women. High blood pressure, high cholesterol, smoking, lack of exercise, diabetes — these have a greater effect in women.
Also, chronic inflammatory conditions like rheumatoid arthritis and lupus may put women at a greater susceptibility for heart disease. During pregnancy, when women have high blood pressure or diabetes, we are finding that those women may be at a higher risk of having heart disease down the line and perhaps their children as well
Women tend to have a greater risk of heart failure and arrhythmia than having just a heart attack, and they tend to present with heart disease later in life than men — typically, about 10 years later.
What symptoms are red flags for heart disease?
One of the biggest ways we can reduce our risk of heart attack is to be aware of changes in how we're feeling.
If you notice a change in your level of fitness — say, you feel tired more quickly or with less activity than before, and you become breathless, start to have chest discomfort or just feel worn out. If it's a dramatic change from how you'd been feeling, then it’s time to talk to your doctor about it.
What can I do if heart disease runs in my family?
Prevention, prevention, prevention!
Your family history does not define you. If you have a strong family history of heart disease, you can make fundamental changes in your lifestyle that dramatically reduce and even counteract that family history.
Doing things like exercising, eating right, not smoking, managing stress and controlling other risk factors — blood pressure, cholesterol, blood sugar if you're a diabetic — makes a dramatic difference.
There are 4 key areas that should be addressed:
Food. Nutrition is extremely important, not just for managing heart disease risk, but to reduce the risk of other diseases — what we call diseases of affluence or the modern man; these are namely diseases stemming from an inactive lifestyle, reliance on convenience foods, etc.
Physical activity. Getting enough exercise and physical activity are fundamentally important to reducing all traditional risk factors for heart disease.
Stress management. Doing something that reduces your level of stress throughout the day is important. We are finding that stress is an underlying cause for many diseases.
To have love. We are finding that having love and social connection are exceptionally important to wellness.
When you put these four modifiable things together in a person's life, you can dramatically reduce heart disease and many other chronic illnesses.
Which women's heart health resources do you recommend?
There are quite a few:
Go Red for Women
American Heart Association
American College of Cardiology
Centers for Disease Control and Prevention (CDC)
These are all great resources for women to use to understand heart disease risks and ways to prevent heart disease.