Transcription:

Bill Klaproth (Host): So, how is women’s heart health different from men’s? What do women need to do to manage their heart health? These are just a few of the questions when it comes to women’s heart health and here to answer those questions and more is Dr. Sujoya Dey, an electrophysiologist at MarinHealth Cardiovascular Medicine | A UCSF Health Clinic and Co-Medical Director of Electrophysiology. Dr. Dey, thank you for your time. So, how is women’s heart health different from men’s

Dr. Sujoya Dey, MD, FACC (Guest): The main way that women’s heart health is different from men’s is that their symptoms for heart attacks can manifest in a different way then men, not all the time, but sometimes, and so how the vessels are affected by the heart disease can sometimes be different in women versus men.

Bill: So, let’s talk about the difference in symptoms then. How are heart attack symptoms different in men than from women?

Dr. Dey: Sure, so the symptoms can often be the same. So, when someone has a heart attack, they often have chest pain in the center of their chest. It can feel like pressure there. It can go into their arm or into their jaw. They can sweat. They can feel uneasy. They also can have some atypical symptoms which women may have, where they feel nauseated like they are going to throw up or they feel lightheaded or dizzy or feel like their heart is racing a mile a minute. Some of these symptoms are more common in women than in men. 

Bill: So, when you talk about these atypical symptoms, those could be other things too, at what point should a woman take it to the next step and think about calling the ER or getting in touch with her doctor?

Dr. Dey: Step one is you have to know yourself and what your symptoms normally are. If you have some of these atypical symptoms of nausea, vomiting, and lightheadedness, the best thing to do is get it checked out as soon as possible. If you are truly having a heart attack, then the more you wait, you can do more damage to your heart muscle because that area of the heart may not be getting enough blood. And if you can get it treated sooner rather than later, it’s much, much better.

Bill: So, at what point should a woman start really thinking about heart health or being more concerned about it?

Dr. Dey: Young adulthood is a great time to go ahead and get checked out, get risk factors assessed. There is a wonderful education manuals and good tool kits on the American Heart Association website and there is a whole section called Go Red for Women, Bill, it is excellent. It really tries to hone in on these particular issues that you are talking about is how should I be alerted, when should I go to the doctor, or what should I ask when I go to the doctor and it is really nicely done. So, that’s a good website to check out and even have some questions in mind before you see your doctor and it can be a regular doctor, it doesn’t have to be a cardiologist.

Bill: So, in general, are there things that women need to do differently from men to manage their heart health?

Dr. Dey: The ways to manage it are quite similar from an individual’s perspective. Prevention, prevention, prevention is the number one job. Number two, if you do have symptoms go to the doctor. Number three if you have a problem and you actually had an event then following what we call secondary prevention is really important. So, you don’t - do everything you can to optimize your situation, hopefully you won’t have any other problems.

Bill: So, when you say secondary prevention, what does that mean?

Dr. Dey: That means that if – say I have had a heart attack. What secondary prevention means is that we don’t want to have any additional problems like further heart attacks or strokes. Go to the doctor and taking good care to manage those risk factors is important and we may be more attuned, and we may have some better targets of where we want the cholesterol or the blood pressures to be if somebody has already had a problem versus somebody who is coming in for the first time and we really are seeing them the lens of primary prevention.

Bill: Right. So, let me ask you this. Are there times in a woman’s life when risk is higher, such as menopause or pregnancy?

Dr. Dey: Absolutely. Those are great questions. During pregnancy, there is increased load on the heart so if there are issues going on with the heart, then that is a time when there is more load on it. So, it is good to get your heart and you whole – a good health check up if you are considering pregnancy or are pregnant. Menopause is also a time when hormonal shift can occur and can unroot some potential chest discomfort and arrhythmia problems that can happen as well. Again, it’s important to not downplay any symptoms, but to understand your body and if there are questions to go ahead and get things checked out with your doctor.

Bill: So, really being in touch with your own body and paying attention to what’s going on is really important. Now we know that stress can be a killer too for men. What about stress in women’s heart health?

Dr. Dey: Yeah, I think that’s the real issue and it can be something that we tend to not give as much value to, but it can have significant impact on your blood vessels, on your blood pressure, on the level of inflammation in your body and getting that assessed and understanding that is really, really, really important and I think as women, we don’t tend to do that as well and perhaps men either. So of course, this is a huge, huge impact on how the vascular disease may present or if it presents at all. Sometimes the stress is the tipping point when things cause people to go from a perfectly healthy bicyclist in Marin County who is doing everything right and then all of the sudden the next thing you know, they come in for a heart attack and you wonder what happened to this person. They are eating all the right foods, they are keeping their blood pressure under control, or are they. They are not obese, so what’s going on. And then you find out after discussing with them that it’s stress that is manifesting and lack of sleep, not eating on the right schedules and these kinds of things can consistently put stress on your body, stress on your vessels and make you more prone to these problems.

Bill: So, Dr. Dey, when it comes to stress, how do you counsel your patients if someone is stressed out?

Dr. Dey: Step one is recognizing this is going on. Recognize you have stress. Step two is talk to your doctor about it and when people come to talk to me about it, I ask them to keep an idea of what their sources of stress are, keep and know that that’s likely affecting other risk factors like if they have arrhythmias or electrical disturbances with their heart that can certainly make it worse. And also, if it is affecting their blood pressure.

For arrhythmia management we have a program called Get In Rhythm for all of our arrhythmia patients, especially who undergo procedures which really focuses on a comprehensive look at these particular problems and stress and what they are eating and specifically in stress like what can we do about it and there’s an excellent set of resources that are available whether it’s through acupressure/ acupuncture, massage, eating the right foods, keeping blood pressure under control, avoiding tobacco, etc. Meditation. These things are really important, and we do that for our arrhythmia patients, those who have electrical disturbances.

Bill: So, again awareness is key as you were talking about. And Dr. Dey, what is your top advice for women who want to manage their heart health?

Dr. Dey: Step one is know your risk factors. That is very important. You have to understand what kinds of things can have a potentially positive and negative impact on your health. Tailor it to who you are. So of course, blood pressure, cholesterol, age, are risk factors, but know your family history because some people may have a higher risk for heart disease if they have a higher family history of this. So, knowing your family history, knowing your potential risk factors is really the most important step in getting informed and getting educated about what to do.

Bill: Well, that makes sense and Dr. Dey, thank you so much for your time today. For more information, please visit mymarinhealth.org, that’s mymarinhealth.org  This is the Healing Podcast brought to you by MarinHealth. I’m Bill Klaproth. Thanks for listening.