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Lee Kirksey, MD  
Male
Cleveland , OH

Specialties: Peripheral Arterial Disease, PAD

Interests: vascular, specialist, treatment options
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Heart Disease and women: the myth

Feb 11, 2010 - 8 comments
Tags:

Heart Attack

,

Chest Pain

,

Women

,

Breast Cancer



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There is a commonly held belief that heart disease falls low on the list of causes of death and disability in women. Far from the truth-the following article from the NY Times addressess some of that misperception by the public

Mention the term "heart attack" and most people imagine a pudgy, middle-aged man drenched in sweat and clutching his chest. Few people seem to consider cardiovascular disease (CVD) as a woman's disease.

But according to the American Heart Association, cardiovascular disease is the leading killer of women over age 25. It kills nearly twice as many women in the United States than all types of cancer, including breast cancer. Only 13 percent of women think heart disease is a threat to their health.

The misleading notion that heart disease is not a real problem for women can be blamed in part on medical research. For a very long time, heart disease studies have focused primarily on men. Changes are under way, but some doctors still fail to recognize the warning signs displayed by female patients.

EARLY HEART SIGNS

Studies have shown that women may have undiagnosed warning signs weeks, months, and even years before having a heart attack.

Significant differences may exist in the symptoms displayed by women and men. Men typically experience the "classic" heart attack signs: tightness in the chest, arm pain, and shortness of breath. Women's symptoms may resemble those of men, but on occasion nausea, an overwhelming fatigue, and dizziness are the main symptoms and are ignored or chalked up to stress. Women have reported that they have had a hard time getting their doctors to listen to them about these early warning symptoms.
Cut and paste for full article

http://health.nytimes.com/health/guides/specialtopic/heart-disease-and-women/overview.html

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by Lulu54, Feb 11, 2010
Dr. Kirksey,

Thanks for bringing this important issue to light.  As a heart attack survivor, I know all too well the statistics of women vs men and CVD.  

Many doctors are often too quick to dismiss women who present with the general complaints of fatigue, dizziness and the other ones you list - many a woman has been sent home being told it was in her head or caused by her hormones, when it was really her heart.

Heart disease is not strictly for the elderly - it is not hard  to find women in their 30's or younger having CVD.

I hope that with efforts such as yours to make people aware of the differences between the sexes, this #1 killer of women will be recognized earlier and prevented more often.  

And for all women out there - please listen to your instincts.  If you know something is wrong with you body, don't be dismissed by your health care providers.  Keep looking for answers - your life may depend on it.

be well,
Lulu
MS forum

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by joanincarolina, Feb 12, 2010
Dear Dr. Kirksey,

Thank you for your time and efforts getting this word out about heart problems in women. I continue to be amazed and somewhat shocked at the lack of exposure by the media in concentrating on the #1 killer and debilitator of women, with the exception of Febuary, The Women's Heart Health Month. My circle of women friends concentrate more on the fears of curable cancers, rare incurable cancers and related diagnostic medical tests but pretty much are not understanding the risk factors and signs of heart problems. I've never had a heart attack but I am the odd woman out when it comes to a heart problem and I'm fortunate to have had control of potential risk factors early in my twenties. I'm a cardiac nurse by training. From 2005-2008 I was on a continous medical intervention path to discover what was causing my complaints of chest pain (variant angina) and shortness of breath. I had enough knowledge to know I was not having typical angina, even for a woman, or having heart attacks. Passing three heart caths (left and right) and multiple other tests it was finally discovered that I had severe cardiac microvascular dysfunction with coronary spasm-common in mostly women and around menopause. My lipids and general health are great, my heart structure and coronaries super, and my head on straight; I just can't exert myself without chest discomfort. To look at me you would never guess there was a thing wrong but as you know this MVD continues to be a developing new cardiac area of research. This is quite debilitating. There is no getting over this dysfunction and no change in diet or lifestyle to make it better but if I hadn't chosen and continued a healthy lifestyle then I would have probably compounded this MVD problem with coronary heart disease. This forum gives me an opportunity to tell women to be persistent and aware of what their body is telling them.I was told so often that the tests were negative and that there was nothing wrong. And most doctors don't readily recognize the various differences within this diagnosis so to my women friends, if you are in discomfort with vague heart complaints, and can't get help, then get to a larger heart center, preferably one that does research. Thanks. Joanincarolina. Cardiac Syndrome X- Microvascular Dysfunction Forum.  

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by pavvi007, Feb 13, 2010

SIR,
  MY FATHER AGE IS 57,AND HE GOT HEART STROKE.DOCTOR DIAGNOSIS THAT.. ACUTE DECOMPENSATED HEART FAILURE,NSAID INDUCED,CORONORY ARTERY DISEASE,SEVERE LV DISFUNCTION.

THIS IS ON 25-01-2010

PATIENT IS CONSCIOUS/COHERENT/AFEBRILE/NOICTERUS/CLUBBING/PALLOR/PEDAL EDEMA

PR :142/MIN      BP:120/90mmHg
HEART : S1+,S2+     LUNGS: C1 CLEAR    CNS :NAD        RR:18/min       JVP :NORMAL       P/A :Soft,BS+

HE KNOWN CAD,OLD AWMI(2006) S/P UROKIKANE S/P CAG--RECONALISED LAD AND SEVERE LV DISFUNCTION ON MEDICAL MANAGEMENT REFERED HERE FROM WARANGAL ASA A CASE OF ACUTE LVF FOR FURTHER MANAGEMENT.C/O SEVERE SOB AND DRY COUGH.NO H/O DM/HTN/APD/TIA/CVA/COPD/Br.ASTHAMA/BLEEDINGDIATHESIS/DRUG ALLERGY.PRESENT HE IS USING MEDICINES...

LASIX 40 MG
PLANEP 25 MG 1/2 TAB
ISMO  20 MG
COPITAB A  75 MG
ATOCOR 20 MG
RAMIPRIL 1.25 MG
CARDIVAS 3.125MG
DIGOXINE .25MG
IVABRID 5MG
FLAVEDON MR 35 MG

LAB INVESTIGATION:
BLOOD SUGAR RANDOM: 91mg/dl      MCH    32.8 p/gms
BLOOD UREA      :             33 mg/dl     MCHC   35.9 %
SERUM CREATININE :       1.4 mg/dl      W.B.C COUNT  7,700 CELL
SERUM SODIUM  :           141mEq/L         NEUTROPHOLS    66%
SERUM POTASSIUM  :   3.5 mEq/L            LYMPHOCYTES             29%
HAEMOGLOBIN       :        14.6  gms%        EOSINOPHILS        05%
P C V                             40  VOL %            PLATELECOUNT 3.39 LAKHS
R B C COUNT              :    4.4 mill/c               E.S.R    05 mm/hr
M C V                    :           91.5 cubic           PHERIPHERAL  SMEAR          RBC :NORMC

OTHER INVESTGATION   2D ECHO:

LA/LV DILATED
LV REGIONAL WALL MOTION ABNORMALITY+
MID DISTAL  IVS, APEX ,APICOANTERIOR WALL THINNED AKINETIC
HYPOKINESIA OF OTHER SEGMENTS
SERVERE L V SYSTOLIC DYSFUNCTION,EF = 18%
GRADE III LV DIASTOLIC DYSFUNCTION
LOW MODERATE MR
MILD TR,NORMAL RVST
NORMAL RV FUNCTION
NOPERICARDIAL EFFUSION /CLOT

CORSE IN HOSPITAL
HE EVALUATED FOR ABOVE MENTIONED HISTORY FOUND TO HAVE CCF WHICH WAS TRAETED WITH IV DIURETICS AND OTHER ROUTINE MEDICATIONS .HE IMPROVED SYMPTOMATICALLY AND GOT DISCHARGE IN A STABLE CONDITION WITH THE ADVICE OF REGULAR MEDICATION AND FALLOW UP .HE WAS ADVISED THE NEED FOR AICD AND/OR HEART TRANS PLANTATION.

FOLLOW UP :

REVIEW IN OPD ON 12 -02-2010  WITH PRIOR APPOINTMENT.

SO PLEASE GUIDE TO US THAT IF ANY NECESSARY OF HEART TRANSPLANTATION OR NOT.

THANK YOU ..

YOURS FAITH FULLY

PAVAN KUMAR C

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by supermum_ms, Feb 14, 2010
Dear Dr Kirksey,

I note your specialties and interests, and wonder if one of my strange sx is something i should be taking more notice of, no idea what is causing this but it does seem logical that if the blood is not pumping through my boody as well as it should be, well could it actually be causing stress on my heart?

I get purple feet which does travel up to my knees, if i dont notice they will turn black, fingers too, cold to touch limbs though i cant feel it internally, just noticed a couple of spide veins starting but no varicois veins. Strangly though the veins all over my body pop up, bulging like blue string stuck to my skin. Breasts, hands, wrists, neck, legs, anckles, just about everywhere, I even get the veins on fingers, palm side, bulging. It seems to be at its worst when i'm active or its hot, oh and it hurts!

For quite a few months prior to this, i had a fluttering squeeze feeling, a spot on the left side of my chest, just off centre, everyday and sometimes all day. It may be coincidental but once this stopped the veins started popping up. April last year i had an event that has not been adequetly identified, neuro did say i had "irrelevant bleeds" and vascular was thrown about though i really just got a pat on the head. The vein issue has been a daily event since about november 09.

I often get light headed, fatigued, its been noted that i sometimes have an irregular heart beat but its never been checked. It does appear as though the blood is pooling at my feet, the veins all the way to my fingers showing themselves seems very odd, i do get brief pain in my right chest once in a blue moon though i've had for weeks discomfort there, more like someone is standing on my chest, though i have the same feeling on my back.

I actually hang out on the MS forum, people there have helped me with so much but this one seems to be a conundrum, could the issue be my heart isn't able to pump the blood through out my body correctly or that the veins are clogging and putting extra strain on my heart? I find this all rather fasinating but i wonder if it should be something i need to get checked out. I should stress i'm not looking for a dx, i dont know anything about sx of heart issues in females, and if anything i've written are early warning signs, i'd like to not be an idiot.

Thankyou for reading!

Cheers.......JJ  

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by Rosey2, Feb 16, 2010
Dear Dr Kirksey thank you for the information could I please impose a question?

I have Sarcoidosis of lungs and skin, my shortness of breath fatigue and dizziness worsened recently but my lung function tests didnt register any changes.  When I asked my lung consultant if there was any need to check out my heart he said 'No' !

When I later whent to GP about palpations and chest pains he did an ECG and told me that it showed problems consistent with possible thickening of the heart muscle and referred me to the Heart Consultant.

The heart consultant arranged an Echocardiogram and said that it showed:- minor bowing of the anterior mitral valve leaflet on closure and that there was a 'wobble' on the left ventricular septal wall.  

He than said that these were not important especially in "Ladies such as myself" when I asked what he meant he said "your age".  I guess he was writiing my problems off as the menopause??   Can I be happy with his dx or should I be pushing harder?



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by joanincarolina, Feb 28, 2010
Dear Dr. Kirksey,
Well, my point has been made. Your article was very good but you need to do it again. We need more women to pay attention to their signs and be very proactive in seeking a reasonable answer until they are satisfied with a response and or can demonstrate that there has been a change, even subtle, in thier cardiac complaints. The Heart forum is filled with women, and men, who ask about vague or real cardiac signs. I read many posts and find them to be valuable information but am often astounded as to why they do not seek immediate attention. It's one thing to ask for help or clarification from Forum members but another to question thier own important signs and defer to a Forum member for help. We need to continue to place emphasis on the number # killer of women, heart disease. Let's not make just February Heart Month. Joan.

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by irfana_saleem, Jul 15, 2011
mr Dr.kirksey,
may i  know  the uses  of  planep 25 mg?
my  mom  hav   heart  disease, she  takes  it  daily...
we   want to  know  about  the   uses  and  function  of  tab planep 25 mg, renerve, metxl 50

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by Annie1310, Jul 19, 2011
Hi there,

My name is Annie and I've been trying to find some answers online to the problems I've been having with heart palpitations which are getting stronger and more frequent, along with a constant pain under my left breast and tiredness.

I went to my GP last week as had four palpitations in 3 hours and was left with a dull ache and heavy crushing sensation in my chest.  I've had palpitations for a few years but they are generally quite light and don't cause any other problems.  She did an ECG which showed a minor blip but felt all was ok, a blood pressure check which was normal and also listened to my heart.  After explaining I was concerned by this new development, she is referring me to a consultant and I should have an appointment within 4 weeks.  

However, on Saturday morning (two days later) I had a bad heavy sensation and dull ache/pain in chest for three hours which eventually passed, but came back again in the evening (also had two minor palpitations during day).  On Sunday felt tired most of the day and abit off colour but around 8pm pain and pressure in chest area again, managed to sleep through the night but woke early with the same pain and pressure.  My husband took me to A&E at local hospital who did the usual checks, blood pressure, ECG, chest Xray.  But they released me after saying although my ECG was 'borderline' for heart damage (again a few minor blips) as everything else checked out ok they felt nothing wrong and that I should wait to see the consultant my GP was referring me to.

Well, I've got up this morning with pain/ache still there but thankfully alittle easier today.  I am still worried about having to wait for appointment as I have a 'gut' feeling there is something going on which they haven't found yet.  My Mum has a leaky heart valve and my Dad had a heart attack at 52yr (I'm 50 and had last period in 2008 if that has a bearing on anything!).  

Also, 6 weeks ago I had a horrific tooth extraction, 20 minutes of tugging and pulling with no movement so Dentist had to resort to splitting tooth in two with drill and removing bit by bit!  He had to change his jacket because of blood and I had to be wiped down.... gives me the chills just thinking about it again.  Anyway the gap left by this tooth went onto become a 'dry socket', most agonising pain I've ever experienced, so to combat this I took 2 paracetamol with 2 ibruprofen every 3 hours for almost two weeks.  Was wondering if this may have had an impact on my heart in any way?  I only bring this up as I took 2 ibruprofen for back pain on Sunday afternoon, then Sunday evening had bad onset of pain/pressure, maybe just a coincidence?  I was given Amoxillian by the Dentist in case of infection but didn't help so gave me Metronidazinole, which did help.

Would love to hear your comments and also your thoughts on whether it'll be ok to wait for the consultant's appointment?  I should add that I live in the UK.  Many thanks, Annie x            

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