Health & Fitness

Heart disease hits women of all ages

WomenHeart Champion Loren Welch, center, laughs after a speech given at her Womenheart support group for women with heart disease at Baptist Health South Florida. Aurora Gonzalez, 80, is at left. Welch, 62, had a heart attack at age 60.
WomenHeart Champion Loren Welch, center, laughs after a speech given at her Womenheart support group for women with heart disease at Baptist Health South Florida. Aurora Gonzalez, 80, is at left. Welch, 62, had a heart attack at age 60. skaestle@miamiherald.com

For most of her life, Loren Welch suffered from acid reflux. But she knew the pain she felt in her chest after eating lunch two years ago was different.

After being taken to the hospital, the 62-year-old wife and grandmother from Homestead went into cardiac arrest and suffered a heart attack. She had to be resuscitated four times and was in a medically induced coma for five days before she had to begin the difficult task of learning how to walk again.

Welch is one of many women fighting heart disease. In fact, more than one in three women are living with cardiovascular disease, including nearly half of all African-American women and 34 percent of white women, according to the American Heart Association. And, on average, Hispanic women are likely to develop heart disease 10 years earlier than their non-Hispanic counterparts. But they often don’t seek immediate treatment as only one in three Hispanic women realizes heart disease is their greatest health risk, the association says.

Cardiovascular disease and stroke are the No. 1 cause of death in American women, claiming more than 400,000 lives annually, or nearly 1 in 3 women’s deaths a year.

Hypertension hits women in their 20s and up

Heart disease affects women of all ages.

More than one in three women are living with cardiovascular disease, including nearly half of all African-American women and 34 percent of white women

Pulmonary hypertension (PH) can go undetected for several years; it also impacts women in their 20s-40s. PH is a type of high blood pressure that affects arteries in the lungs and the right side of the heart. It can lead to shortness of breath, dizziness, fainting, leg swelling and other symptoms. Eventually, if the right side of the heart fails or cannot withstand the pressure, it will enlarge and possibly lead to right heart failure.

Some women may have idiopathic pulmonary hypertension, a form of PH where the cause is unknown. But more commonly, women suffer from pulmonary hypertension caused by medical conditions, including sleep apnea, scleroderma (an autoimmune disease that can damage the organs), lupus, AIDS, emphysema or blood clots in the lungs.

In the early stages of PH, the symptoms tend to be more subtle, said Dr. Shirin Shafazand, associate professor of medicine at University of Miami Miller School of Medicine and director of pulmonary hypertension clinic at UHealth-University of Miami Health System.

“The main symptoms in women can be simply they are getting more tired than usual or they are experiencing shortness of breath where they didn’t experience it before,” Shafazand said.

These subtle signs make the disease difficult to diagnose. It can take up to two and a half years to diagnose because more common causes for low energy or shortness of breath have to be ruled out through testing. An echocardiogram, or ultrasound of the heart, is one of the main tests to determine a definitive diagnosis, Shafazand said.

While there is no cure for pulmonary hypertension, a patient can live a relatively normal life with proper care and medication.

While pulmonary hypertension is one of the main causes of heart disease in women, so, too, can be breast cancer. Although chemotherapy and radiation therapy improve the outcome of many breast cancer patients, some of the treatments can affect the heart, said Dr. Diego Sadler, a cardiologist at Cleveland Clinic Florida in Weston. Years after treatment, a breast cancer survivor may suffer from congestive heart failure or coronary disease where blood vessels are blocked.

Breast cancer and heart disease entwined

Breast cancer survivors with additional risk factors such as hypertension, diabetes, high cholesterol or smoking also are more likely to develop heart disease after receiving chemotherapy and radiation.

To combat this problem, a new specialty has developed in the past few years called cardio-oncology, where cardiologists and oncologists provide breast cancer treatment and minimize the risk to the heart, Sadler said. Cleveland Clinic Florida is launching a cardio-oncology clinic within the next few months to provide care for cancer patients with heart issues.

Sadler noted recent studies that determined systematic imaging in a patient’s chemo treatment can provide early detection of heart dysfunction. Strain imaging, a type of echocardiography, detects subtle changes in the heart function before major changes have occurred. Cardiologists and oncologists can use this early detection to adjust a chemotherapy regimen to minimize the damage to a patient’s heart.

Heart disease survivors working together can also impact a patient’s life. The Miami Cardiac & Vascular Institute (MCVI) at Baptist Health South Florida is a founding member of the WomenHeart National Hospital Alliance, a program of WomenHeart: The National Coalition for Women with Heart Disease. The national organization operates patient-led support groups for women affected by heart disease.

The WomenHeart chapter in Miami has about 85 members. It was the nation’s first chapter to form a support group for Spanish- speaking members as well, said Susan D’Agostino, R.N., manager of the WomenHeart Support Network at Baptist Hospital. Both the English and Spanish groups meet monthly at MCVI.

Welch, the woman who went into cardiac arrest after eating lunch, is sharing her story as a WomenHeart Champion, a volunteer leader trained to educate women about prevention, diagnosis and proper treatment for heart disease.

“They are able to support someone else in an entirely unique way that a physician or someone else could not because they have walked in their shoes,” said Annie de Velasco, R.N., coordinator of the WomenHeart Support Network at Baptist.

D’Agostino and de Velasco are no strangers to heart disease. De Velasco is a heart attack survivor; D’Agostino is at a high risk for heart disease with a strong family history of heart attacks, heart surgeries and early deaths from heart disease.

“Even though I am a nurse, I was totally unprepared to have a heart attack, as most people are,” de Velasco said. “When I first had my heart attack, I was as scared as the next patient.”

While in the cardiac rehabilitation program at Baptist, de Velasco met D’Agostino and joined forces to become two of the founding members of the support group in Miami.

“l really found it was my passion to give back,” de Velasco said. “To make sure other people didn’t have to go through what I went through, which was fear and anxiety.”

Welch credits her WomenHeart training with revitalizing her life after her health setbacks.

“I was able to overcome most of my depression,” Welch said. “I can now go out there and intermingle with people without crying. You have to be strong and have faith in yourself. I learned that although you had a heart attack, life goes on.”

If you go

WomenHeart Support Network meetings for English speakers are from 6:30 to 8:30 p.m. the third Thursday of every month at the Miami Cardiac & Vascular Institute at Baptist Hospital, 8900 N. Kendall Dr.

WomenHeart en Español meets from noon to 1 p.m. the fourth Monday of every month at the Miami Cardiac & Vascular Institute at Baptist.

For information, call 786-596-6564.

Heart Attack Symptoms in Women

As with men, women’s most common heart attack symptom is chest pain or discomfort. It can be an uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It may last more than a few minutes, or go away and return.

But women are somewhat more likely than men to experience some of these other common symptoms of a heart attack:

▪ Neck, jaw, shoulder or abdominal discomfort

▪ Upper back pressure that feels like a rope being tied around you

▪  Shortness of breath, even if you haven’t moved

▪ Right arm pain

▪  Nausea or vomiting

▪  Sweating

▪  Lightheadedness or dizziness

▪  Unusual fatigue

Source: American Heart Association

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