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Standard =
Test
Misses Heart Disease Signs in Women By Amanda Gardner TUESDAY, Jan. 31 (HealthDay News) --
Standard diagnostic testing can miss the warning signs of heart disease in
women, a large This is because plaque tends to collect =
in
the smaller vessels in women, while it builds up in the major arteries in
men. Unfortunately, routine angiographies ten=
d to
pick up only significant blockages in major arteries, according to results
from the National Institutes of Health=
-sponsored Wom=
en's
Ischemia Syndrome Evaluation (WISE) study, initiated in 1996 to look at h=
eart
disease in women. As many as 3 million "This just increasingly validates t=
hat
we're learning more and more about women every day, and that it calls for=
a
mechanism of heart disease that frequently goes undiagnosed," said D=
r.
Nieca Goldberg, chief of women's cardiac care at Lenox Hill Hospital in N=
ew
York City and author of The Women's Healthy Heart Program. "Women and physicians should pay
attention to symptoms related to the heart," added Dr. George Sopko,
WISE project officer for the National Heart, Lung and Blood Institute. The study appears as a special supplemen=
t to
the Feb. 6 issue of the Journal of the American College of Cardiology<=
/i>,
and is available online on Jan. 31. Ischemic heart disease (IHD) is the lead=
ing
cause of death in the Yet, traditional disease management seem=
s to
overlook problems in women. In particular, coronary angiography, an X-ray
examination of the blood vessels and chambers of the heart, is not specif=
ic
enough to detect problems in women, the researchers said. "The coronary angiogram provides
anatomical information about the location of the blockages, and how much =
they
block," Sopko said. "The angiogram doesn't provide information
about what happens within the wall." WISE investigators found that a majority=
of
women who were given an all-clear on their angiograms continued to have
symptoms along with repeated testing and hospitalizations and a declining
quality of life. "We found that women who have no
significant blockages but have evidence of ischemia are at a high risk for
future heart attacks, repeat hospitalization or even death," Sopko s=
aid.
"That was noted in small studies before but nobody had such a big
cohort." "When women go for an angiogram and
they don't find blockages, it doesn't mean they don't have a problem. It
means the problem's not caused by build-up of plaque," Goldberg said.
"It doesn't mean that the symptoms aren't coming from the heart. They
can come from very small blood vessels that we don't see in standard
testing." The question: What do you do in women who
have symptoms but no significant blockages? The answer: Don't ignore the problem. "This is looking at women who might
have been discarded. Now we're saying you don't have the big blockages but
you've got some problems, so let's go look," Sopko said. "You d=
on't
neglect or deny medical therapy to these women." An added problem, however, is that there
isn't much non-standard testing to detect these kinds of problems, Goldbe=
rg
said. "Unfortunately, for this particular
mechanism we don't yet have all the tools we need," Goldberg noted.
"Clearly, when it comes to women and heart disease, we can't take for
granted that it's going to be exactly to the same script as men." More information For more on women and heart disease, vis=
it
the Na=
tional
Heart, Lung, and Blood Institute. |
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