Heart Disease in Women Live Chat – Emory Heart & Vascular Center

EHC: Welcome everyone! Thanks for joining us for our Heart Disease in Women web chat with Dr. Alexis Cutchins of Emory Heart & Vascular Center.

EHC: We’ll get started in just a minute.

EHC: Please note, all questions are moderated before showing, so you may not see yours right away, but we’ll do our best to get to all your questions.

EHC: We received some questions in advance, so we’ll get started by answering a few of those first.

Q: The first question we received ahead of time was “How does on and off depression affect your heart?
A: Long term depression is associated with increased risk for ischemic heart disease and palpitations/arrhythmia. If depression is intermittent or well treated it should not increase your risk.

Q: The next question was “Are arrhythmias considered heart disease?
A: Yes. However, arrhythmia is its own subset. You can have a diagnosis of arrhythmia but that does not mean you have coronary heart disease.

Q: What are the signs of a heart attack in women?
A: There are many different signs/symptoms of a heart attack in women. Usually women present with chest pressure that radiates to the arm, neck or jaw and is associated with SOB, nausea, sweating or palpitations. More women than men, however, will present with atypical symptoms including flu-like symptoms, GI upset like reflux or isolated jaw or arm pain without chest discomfort.

Q: The last question we’ll address before moving on to live questions is “How long is life expectancy with heart disease?”
A: That is a great question, probably one that I am not able to answer. It depends on the type of heart disease and whether a patient follows their doctor’s recommendations for diet, exercise and medications.

EHC: Let’s move on to your live questions now!

EHC: Don’t forget to sign in using one of the options at the bottom of the chat and submit your questions for Dr. Cutchins in the comment box.

Guest5602: Excited that Emory is brining so much attention to healthcare. I have 7 cardiac stents and if it had not been for primary care doctor who had worked in an ER and seen the unusual symptoms I may not be here today. I presented with flu like symptoms and pain through my back. At 28 I had a 98% blockage in the LAD but I had been diagnosed as being slightly depressed as so as soon as I had angioplasty all depression symptom left. I am 53 and have been dealing with heart disease since 28.

EHC: That’s fantastic! We’re so happy that you’re doing well and sharing your story.

EHC: We frequently see patients who present with flu like symptoms or gastrointestinal symptoms that end up having heart disease.

Guest8092: What does SOB mean?

EHC: SOB = Shortness of Breath

EHC: I recommend a Mediterranean diet to all my patients. It includes a diet rich in omega 3 fatty acids, nuts, fatty fish like salmon, olive oil, avocados and unprocessed foods.

Guest5849: In managing congestion heart failure, is a pacemaker a common?

EHC: Depends on why you have congestive heart failure. There are some specific cases where a pacemaker is recommended to improve the cardiac function. We often recommend an implantable cardiac defibrillator for patients with an ejection fraction of less than 35% to prevent sudden cardiac death.

Guest5602: What kind of Studies can women get into at Emory for Heat Disease?

EHC: We have an ongoing project to screen 10,000 African American women for hypertension. Plus there are folks doing research on micro vascular disease which is a subset of heart disease that affects more women than men. We also have ongoing clinical trials for resistant hypertension and valvular heart disease. We suggest seeing an Emory cardiologist for more information.

Guest8092: How do you know if you have the flu or you are experiencing heart problems if they are similar? What are other indicators that you may be starting to have heart problems?

EHC: Sometimes it’s hard to distinguish between the two. If you’ve been around others with flu like symptoms, it probably is a virus. However, if you have flu like symptoms w/o fever, that are progressive, you should seek medical attention, especially if symptoms worsen with exertion. There are simple tests that we can do in the emergency room that can tell us if you’re having heart issues.

Guest8099: I have a heart murmur. Do I need a cardiologist?

EHC: It depends on the type of murmur, your age and if you have any cardiac symptoms. There are benign murmurs found with pregnancy or anemia. It would not hurt to see a cardiologist if you have concerns.

Guest7751: Any particular nutritional lifestyle changes (diet) recommended?

EHC: Again, a Mediterranean diet is recommended. Google is a great resource for recipes and guidelines.

EHC: Here are a few more pre-chat questions we received.

Q: What signs should I look for in the women in my life?
A: I tell people to look for subtle things like an unexpected decrease in exercise tolerance. If she has been doing the same amount of exercise on a regular basis, then suddenly cannot achieve that exercise anymore or it is much harder to do then that is a sign she should come in and get her heart checked out.

Q: What do you need to start getting screening?
A: A good time to get screened is in your 40s. Earlier if you have a strong family history or a history of gestational diabetes, gestational hypertension.

EHC: Hi Guest8851, it looks like your question was cut off. Please resubmit it when you have a moment.

Q: How much exercise is needed for a 60-year old female to be heart healthy?

A: I usually recommend at least 30 minutes of walking a day…the more the better.

Guest8092: Do diets have any effect on experiencing arrhythmias or does it only make a difference in coronary heart disease cases?

EHC: Patients with low potassium or magnesium levels are more susceptible to suffer heart rhythm abnormalities. However, a Mediterranean diet is appropriate to follow for all cardiac patients. Those cardiac patients with heart failure should also follow a low sodium diet, so there are variations for separate cardiac conditions.

Guest8099: Is cholesterol medication necessary?

EHC: It depends on your cholesterol levels. We prefer women to have an LDL (bad cholesterol) goal of 50.

EHC: Here’s a pre-chat question that may be relevant to Guest8099’s question:

Q: What should be done when I have a high calcium score from a heart scan?
A: A high calcium score indicates plaque buildup in your arteries. Usually we recommend a cholesterol medication for this but every patient is different.

Q: I’ll be 53 in next month and am on medication for high blood pressure + high cholesterol. Both of my parents had heart disease including heart attack and stroke. When should I start seeing a cardiologist to monitor the health of my heart?
A: I recommend that you make an appointment with a cardiologist to review your risk and establish individual care guidelines.

Q: How do you know when chest pain needs to be checked out?
A: If you’re having chest pains that do not go away then you should go to the emergency room. If you have chest pains that come on with exertion and go away with rest, this is potentially concerning and should be checked out by a cardiologist. Some chest pains can be consistent with reflux or musculoskeletal pain however if there is any question at all, the pain should be evaluated by your primary care physician or cardiologist.

EHC: Today’s questions have been great!

EHC: We’re going to wrap up a bit early unless there are any more questions.

Guest3883: Thank you

EHC: Any remaining questions will be answered by Dr. Cutchins in a post-chat Q&A on our blog, AdvancingYourHealth.org.

Guest8092: Is there a difference btw arrythmia’s and what people call heart palpitations? Like when someone scares you and your heart races or other rapid heart beats?

EHC: One can experience a symptom of extra heart beats or heart racing which can either be a quickening of your natural heart rhythm or a rhythm abnormality. Usually serious heart rhythms result in associated symptoms like shortness of breath, lightheadedness or even syncope (passing out).

EHC: That’s all the time we have for today. As we mentioned, we’ll follow up with a blog post to answer any questions we didn’t get a chance to answer today.

EHC: Again, thank you for joining us and have a great day!

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