It's The Heart That Matters Most

I live in Europe where cardiovascular disease is the leading cause of death 1. Coronary heart disease (CHD), the likely precursor to myocardial infarction (MI) or heart attack, is the leading killer in Western nations and is increasing in developing countries as they increase their consumption of animal products 2. Incidentally, MI may be silent, or manifest as prolonged pain and discomfort as associated with simple angina 2. Diagnosis of coronary artery disease in women is more difficult because of lower specificity of symptoms and diagnostic accuracy of noninvasive testing, in other words, woman may be difficult to read 3. Comparatively, men are more likely to experience crushing substernal chest pain, whereas woman are more likely to experience shortness of breath, jaw or back pain, nausea / vomiting 2. Analogously, the symptoms in woman are multi-colored however, in men more like black and white. Moreover, women are at greater risk for worse outcomes associated with acute coronary syndrome (a medical condition caused by or involving disease of the coronary arteries, including angina pectoris and heart attacks, ACS) than are men, possibly because they tend to be treated less aggressively than men, even when more aggressive treatment is needed 4. Elsewhere, in China, female patients with (ACS) were older than male subjects and thus more often had concomitant (happening or existing along with or at the same time as something else) diseases further complicating the situation 5. Similarly, In Korea invasive treatment was more commonly performed in males than females 6. Unfortunately, proper cardiac care for woman may be delayed or misguided because caregivers as well as patients may believe that woman are not at significant risk for cardiac disease 2. Perhaps raising local awareness of ACS signs and symptoms may save the lives of mothers and daughters here and elsewhere.

eddie S

References:
1. Abreu A, Bettencourt N, Fontes P: Overview of cardiac rehabilitation in Portugal 2007-2009, Rev Port Cardiol 2010, 29:545-558
2. Barnard ND, Reilly JK, Weissinger R, Jaster BJ, Kahan S, Smyth C: Nutrition Guide for Clinicians. Edited by Washington, DC, Physicians Committee for Responsible Medicine, 2009, p.pp. x, 745 p.
3. Wiviott SD, Cannon CP, Morrow DA, Murphy SA, Gibson CM, McCabe CH, Sabatine MS, Rifai N, Giugliano RP, DiBattiste PM, Demopoulos LA, Antman EM, Braunwald E: Differential expression of cardiac biomarkers by gender in patients with unstable angina/non-ST-elevation myocardial infarction: a TACTICS-TIMI 18 (Treat Angina with Aggrastat and determine Cost of Therapy with an Invasive or Conservative Strategy-Thrombolysis In Myocardial Infarction 18) substudy, Circulation 2004, 109:580-586
4. Tavris D, Shoaibi A, Chen AY, Uchida T, Roe MT, Chen J: Gender differences in the treatment of non-ST-segment elevation myocardial infarction, Clin Cardiol 2010, 33:99-103
5. Song XT, Chen YD, Pan WQ, Lu SZ: Gender based differences in patients with acute coronary syndrome: findings from Chinese Registry of Acute Coronary Events (CRACE), Chin Med J (Engl) 2007, 120:1063-1067
6. Lee KH, Jeong MH, Ahn YK, Kim JH, Chae SC, Kim YJ, Hur SH, Seong IW, Hong TJ, Choi D, Cho MC, Kim CJ, Seung KB, Chung WS, Jang YS, Cho JG, Park SJ: Gender differences of success rate of percutaneous coronary intervention and short term cardiac events in Korea Acute Myocardial Infarction Registry, Int J Cardiol 2008, 130:227-234