The Heart of the Matter: Essential Tips for Women's Cardiovascular Wellness

Taking care of your heart involves a combination of regular check-ups, a healthy diet, regular exercise, and listening to your body. Remember, it’s never too late to start taking steps towards a healthier heart.

During a recent Ask the Expert live video event, cardiologist Anna Tomdio, MD, FACC, and clinical exercise physiologist Shari Denecke shared valuable insights about women’s heart health.

Women's Heart Health: Unique Challenges

Women face unique heart health challenges compared to men. For instance, gestational diabetes and hypertension during pregnancy can increase a woman's risk of cardiovascular disease later in life. Another condition more common in women is microvascular disease, which requires specific testing. These conditions highlight the importance of gender-specific considerations in cardiac health.

Cardiovascular Disease in Women

It’s important to note that cardiovascular disease is more prevalent than breast cancer, with one in five women dying from it. Yet, only half of women in the United States are aware of this. Women often present with atypical symptoms, which can sometimes be overlooked. Therefore, it’s crucial that women do not ignore their symptoms and seek medical advice if they experience anything unusual.

Choosing a Cardiologist: What Women Should Look For

When choosing a cardiologist, women should look for someone they can trust and who has experience in their specific area of concern. It's essential to feel at ease with your cardiologist and trust their expertise. If they lack experience in a particular area, they should be honest about it and refer you to another specialist if necessary.

Cardiopulmonary Rehabilitation: Who Needs It?

Cardiopulmonary rehabilitation is a crucial part of recovery for patients who have suffered a cardiac event. To qualify for cardiac rehab, patients need a physician's referral and a diagnosis that meets specific criteria. These include a heart attack, chest pain or angina, stents / angioplasty, open heart surgery, heart failure, valve replacements or repairs, and heart transplants.

Enhanced External Counter Pulsation (EECP): A Solution for Chronic Chest Pain

EECP is a procedure used for patients who have chronic chest pain to the point that it hinders their daily activities. The procedure involves placing cuffs around the patient's legs to help push blood back up to their heart, improving blood flow and helping the body grow new blood vessels. This results in less angina, more energy, and a better quality of life.

When to Worry About an Ascending Aneurysm

An ascending aneurysm refers to the expansion of the large artery that comes out of your heart. It is an artery that supplies branches, hence blood flow to all the parts of the body. The size of the aneurysm dictates when an intervention is needed and this in turn depends on if the patient has an underlying connective tissue disorder.

Primary and Secondary Prevention of Heart Disease

Primary prevention involves checking your blood pressure, cholesterol, and screening for diabetes. If any of these are present, they need to be treated. Another significant risk factor for heart disease is obesity. We recommend exercise, dietary changes, specifically the Mediterranean diet, and in certain circumstances, bariatric surgery.

Practicing a healthy lifestyle consisting of adequate regular exercise, a heart healthy diet, good sleep hygiene, staying smoke-free, and managing stress are all pieces of primary prevention.

Secondary prevention is when a diagnosis or problem already exists, and steps are taken to prevent its progression or prevent events from happening again.

In both circumstances, lifestyle modifications are highly recommended, including but not limited to dietary changes, at least 150 minutes of moderate exercise per week, stress management, tobacco cessation, and medication adherence.

Do All Women with High Cholesterol Need to Take Medication?

The need for medication is very individualized and depends on the risk factors that a particular woman has. For example, a woman with a strong family history of coronary artery disease, obesity, or diabetes is at higher risk of having coronary artery disease or some kind of cardiovascular disease, and that person should be on medication.

On the other hand, for a slightly overweight woman with no family history, hypertension, or other cardiovascular disease risk factors whose cholesterol is elevated, lifestyle changes may first be recommended.

Many patients, particularly women, often wonder if they can stop taking medication for conditions like high cholesterol or high blood pressure at some point. The answer is, potentially, yes. If patients make significant lifestyle changes such as weight loss, drastic changes in their diet, and regular exercise, they could potentially come off these medications.

Understanding Heart Rhythms: PVCs and PACs

Our heart has four chambers - two top chambers (atria) and two bottom chambers (ventricles). PACs are extra beats that come from the atria, while PVCs are extra beats that come from the ventricles. These extra beats can occur in anyone at some point. However, if the number of these extra beats within 24 hours is high, it could be a cause for concern and may require medication.

Valve Prolapse and Regurgitation

Valve prolapse means that one of the leaflets from your valve, typically the mitral valve, is bulging into the atrium. This could sometimes be associated with regurgitation, which means that instead of blood flowing from the top chamber into the bottom chamber, some of it may go back into the top chamber.

Calcium Scoring

Calcium score is a CT scan that measures the amount of calcium building up in your heart arteries. If the score is less than 100, it’s not as concerning, but it still shows that there’s some plaque building up in the heart arteries. A score between 100 to 400 is more concerning, and anything greater than that is of higher concern.

Exercise Recommendations

The American College of Sports Medicine recommends at least 150 minutes of aerobic exercise per week. This could be as simple as a brisk walk for 30 minutes, five days a week. For women over 60, it’s also recommended to include some strength training in their routine to increase the density of their bones.

Diet Recommendations

A Mediterranean diet is highly recommended. This includes olive oil, unsalted nuts, fish, salads, and feta cheese. Fresh fruits like strawberries and blueberries also make for great heart-healthy snacks.

The Importance of Regular Check-ups

Regular check-ups with your primary care provider are crucial, especially if you have risk factors for heart disease. These check-ups can help manage conditions like hypertension and diabetes and monitor symptoms that could indicate a heart condition.

Meet the Experts

Dr. Anna Tomdio is a cardiologist with Mary Washington Cardiology. She is a specialist in cardiovascular disease and an interventional cardiologist with expertise in coronary artery disease, cardiomyopathy, high cholesterol, and diabetes. Dr. Tomdio specializes in treating heart attacks, congestive heart failure, and valvular heart disease. She is certified by the American Board of Internal Medicine in Cardiovascular Disease and Internal Medicine, a board-certified Diplomate of Adult Comprehensive Echocardiography, and a fellow of the American College of Cardiology.

Shari Denecke is a clinical exercise physiologist in the Mary Washington Hospital Cardiopulmonary Health and Fitness Department. She provides cardiac rehabilitation for patients who have suffered a cardiac event. Shari focuses on educating patients about stress management, nutrition, risk factor modification, benefits of exercise, and medication management.