A Woman’s Heart

Allen Weiss, M.D. Allen Weiss, MD, MBA, FACP, FACR

President, NCH Healthcare System

February 8, 2006 - A wonderful gift this year for Valentine’s Day would be better heart disease prevention and treatment for the people we love. More women die unnecessarily from heart disease than from breast cancer or the next top five causes of death combined, according to Dr. Lynda Rosenfeld, who happens to be my sister-in-law. An acknowledged expert on women’s cardiovascular issues, Dr. Rosenfeld is also an Associate Professor of Medicine and Pediatrics at Yale University College of Medicine.

Why should women be discriminated against in the diagnosis of heart disease? Why do women have a worse prognosis than men even after heart disease is discovered? What puts women at risk? What can be done?

During February we think of hearts as we celebrate the romantic occasion of Valentine’s Day. The American Heart Association, on the other hand, focuses our attention this month on heart disease. We all need to understand more about this problem in relation to women, in order to improve the health of the special females in our lives.

Women commonly either ignore or deny their own symptoms of heart disease or heart attacks. Traditionally care givers rather than care receivers, women tend to minimize concerns about themselves. Many recent medical studies have confirmed these findings, while also showing that delays in seeking treatment worsen disease and prognosis. Furthermore, women rate their cardiac disease as less severe than do men even after taking into account other measures of cardiac disease severity according to an American Journal of Medicine article this past November. Recognizing and admitting that one has a problem is the first - and perhaps the most important - step in stopping the heart disease discrimination against women.

Women are less likely than men to have the classic signs of angina or heart attack. Angina is a symptom often described as a “squeezing” or “heaviness” in the left side of the chest. Caused by hardening and narrowing of the arteries, it reduces blood supply to the heart. Pain or discomfort in women may be located in the upper abdominal area and can be mistaken for heartburn or indigestion. Women may have nausea, fatigue, weakness, dizziness, shortness of breath, and arm or jaw pain. Or a woman may just not feel well in a non-specific way and ignore these symptoms. The lack of classic symptoms combined with denial leads to delays, thus increasing the chances for a fatal first episode.

Importantly, risk factors are not gender specific. Smoking, poorly controlled high blood pressure or diabetes, excessive weight, minimal exercise, high cholesterol, age and family history all contribute to the chances of anyone developing heart disease. We can all help each other by encouraging healthy life styles.

Locally, the NCH Healthcare System facilitates healthy life styles by the Wellness Programs located on both Immokalee Road in the Greentree Shopping Center and, currently, on Goodlette Road at Grand Central Station. This fall, the downtown Wellness facility will move to a beautiful new signature building at the corner of 4th Avenue North and Tamiami Trail North. Combined, these programs have about seven thousand members, more than 130 classes each week and an average participation age over 50. People who exercise at least two hours per week have half the chance of suffering a heart attack.

NCH Healthcare System has been recognized by two independent hospital review organizations as demonstrating exceptional quality in cardiac care. HealthGrades has recognized NCH as being a top 5% hospital overall, with specific accolades in cardiology. Solucient has just included NCH in its top 100 hospitals in the care and treatment of heart attack, congestive heart failure, cardiac bypass, and angioplasty. There are over 5,000 hospitals evaluated for these awards that are given based on objective information and careful evaluation, not self-declared boasting or previous reputation.

We can stop the catastrophe of women not recognizing they have heart disease. At the same time, we can improve everyone’s health and well-being by understanding and controlling the risks of heart disease. Sharing these thoughts with the women you love are the best gifts you can give this February 14th. Please have a healthy and wonderful Valentine’s Day.

Dr. Allen Weiss is President of the NCH Healthcare System. He is board certified in Internal Medicine, Rheumatology and Geriatrics, and was in private practice in Naples, Florida from 1977 - 2000. Dr. Weiss is active in a variety of professional organizations and boards, and has been published in numerous medical journals, including the American Journal of Medicine and the Journal of Clinical Investigation.