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“НАШЕ ЖИТТЯ”, ЛЮТИЙ 201 2 WWW. UNWLA.ORG 33 Heart Disease in Women Ihor Magun, MD, FACP Dur ing an acute presentation of a heart attack, the typical symptoms of heavy chest tightness and pressure present in men are not usually seen in women. Women present symp - toms labeled as "atypical" — shortness of breath, weakness, or presence of unusual fatig ue. As - sociated with these symptoms or independent of them is a feeling of lower chest discomfort and upper abdominal pressure that may be accom - panied by nausea. This may erroneously lead to a diagnosis of a gastrointestinal ailment. The causes of dis com fort are primarily due to com promised circulation in the heart. When the blood flow is blocked, some women may experience some type of chest discomfort characterized by a pressure or a squeezing sen sation in the chest. This may radiate to the jaw, arms, back, or shoulder. There may be sweat ing for no apparent re a son as well as a sudden extreme fatigue or a feeling of "doom." Some women, especially diabetic, present the so - called "silent" heart attack (this is also seen in diabetic men). What th is means is that there was per manent damage to the heart with no antecedent symp toms. These silent heart attacks are notorio us for being discovered only incidentally, during a rou tine electrocardiogram, or when some cardiac symp - toms occur, and an ele ctrocardiogram re veals changes consistent with the damage pattern pro - duced. Complicating the cardiac issues in women is the female - pattern coronary artery disease . The narrowing of the coronary arteries may occur as a result of deposits of fatty cells, calcium, and in - flammatory cells. These can be visualized as pro - trusions in the vessel walls. Men tend to have one or several affected areas , scattered throughout the heart. The female - pattern coronary artery disease presents as a diffuse plaque, narr owing the entire circumference of the artery t hroughout. In fact, cardiac catheterization (placing dye in the blood vessel of th e artery with visualization over an x - ray ) may show that the vessels are normal when, in fact, there is diffuse disease. This l eads cardio - logists to assume that all is well and dis count a cardiac issue. A new technique, not yet routinely done during cardiac catheterization , is called intra vas - cular ultrasound IVUS. This procedure involves an insertion of a special device int o the co - ronary artery via t he groin area. This provides direct visualization from within. Many women who were previously though t to have normal coronary arteries have had plaque identified through this procedure . It would seem intuitive that if there is diffuse disease, the management of narrowed vessels should differ from localized blockages. Localized issues a re managed with local measures — stents , use of balloons , and other techniques. With diffuse disease , the key is to reduce risk factors (a measur e that is recom - mended to all cardiac patients). This is done through a ddressing cholesterol issues, reducing clotting risk with use of aspirin, and initiating medications that strengthen the heart — medica - tions referred to as beta - blockers and ACE inhi - bi tors. Talk to you r physician about your symp - toms and know the atypical warning signs. Arm yourself with the correct knowledge to help yourself and other women identify cardiac disease that could be easily missed. З листів до Редакції Шановні Пані! [...] З Новим Роком 2012 залучую найщиріші вітання. Нехай Бог благословить Вашу працю для українців, а передовсім для України. Щастя, здоров’ я і многих літ та витри в алости. Висловлюю щиру подяку за точне одержання журналу, котрий люблю читати і переживати п одії організації, бути все з Вами. З пошаною , Яніна Пилипчак, колишня членка 7 1 - го Відділу СУА.
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