What kills half a million women a year, afflicts 1 in 3 women over 65, strikes 9,000 women under 45 each year, effects women a decade later than men and has killed more women than men since 1984? Heart disease. And another scary thing is — only 8 percent of women in the U.S. know they are at risk for cardiac disease, according to a 2002 American Heart Association study. Other studies show most women fear breast cancer far more than heart disease, yet breast cancer claims 1 in 8 women’s lives while heart disease kills 1 of every 2.

This month our Women’s Health section dives deeper into imaging the female heart as well as providing updates on the breast imaging and bone densitometry markets.

Outreach, outreach, outreach is the battle cry of women’s cardiac professionals these days. A good friend of mine, Patty Shea, is a nurse practitioner at The Women’s Cardiac Center at The Miriam Hospital in Providence, R.I., one center strongly supporting the fight. She’s educating educated women — many of whom are shocked by their newly found heart disease — about what they can do to fight back.

Eat less, move more, she says. That’s good advice for women and men, but women and the practitioners who care for them, also need to know about the peculiarities and vagueness of heart attack symptoms in women: Shortness of breath, extreme fatigue (that can mimic autoimmune disease symptoms), nausea, bad indigestion, uncomfortable chest tightness, flu-like symptoms lasting weeks and a feeling of doom. And even more unusual are complaints of toothaches and elbow pain.

Truth is, women are less likely to seek out care for heart attack symptoms or seek treatment typically later than men. It’s simple. Very few women walk into an ER saying, “I think I’m having a heart attack.” And once they present at the ER (especially if they are premenopausal), they are less likely to get immediate care such as clot busters or angioplasty — although that is changing.

Women are from Venus and men are from Mars when it comes to diagnostics, too, as it is less likely to see the plaque ruptures after a heart attack in women that are commonly seen in men. Why? The jury is still out but maybe because plaque occurs in the smaller branches of the heart or spasms are more common in women. Smaller size stents and guidewires are improving angioplasty success rates in women, too.

As we know, cardiac imaging — nuclear medicine, stress echo, cardiac cath, calcium scoring and cardiac MR — is opening physicians’ eyes to what is wrong and thus what to treat, but women have to recognize the symptoms to ask for help.

The action plan? Eat right, exercise for 30 minutes most days, stop smoking, de-stress and get your cholesterol in check — did you know that only 15 percent of your cholesterol comes from food, while 85 percent is genetic?

Knowing and acting on heart attack symptoms will increase the odds of survival for everyone.

Mary C. Tierney, Editor
mtierney@mwc.com