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Conditions We Treat
Q: I've heard about a new type of artery disease that affects women. What is it?Ask Our Expert About Hidden Heart Disease
Q: I've heard about a new type of artery disease that affects women. What is it?A: In this condition, cholesterol plaque spreads evenly within the walls of the arteries rather than forming major blockages. The condition has been called by different names-hidden heart disease, microvascular syndrome, endothelial dysfunction, syndrome X. It may affect as many as 3 million American women. Q: What are the symptoms?A: The main symptom is chest pain or discomfort. But the condition does not show up on an angiogram-the most common test for coronary disease-because since there are no actual blockages, the arteries look clear on the X-ray. Q: Why is hidden heart disease dangerous?A: It causes narrowing of the arteries and reduced blood flow to the heart. Healthy arteries are able to dilate when the heart muscle needs more oxygen-laden blood. In a person with hidden heart disease, the arteries don’t respond as they should. That raises the risk for heart attack and stroke-yet the patient isn't aware of her increased risk because her arteries appear fine in the angiogram. Q: How was hidden heart disease discovered?A: We've known for some time that this condition exists, but didn't realize how common it is until the findings of a major study were published recently. The study, called WISE (Women's Ischemia Syndrome Evaluation), included 936 women who had symptoms that led their doctors to order angiograms. Only a third of the women had obvious blockages. But of those without blockages, more than half turned out to have artery abnormalities such as the inability to dilate. Q: How do you test for hidden heart disease?A: We don't know yet what the most effective tests will be. The researchers in the study used a type of stress test to measure coronary flow velocity-how fast and well the blood flows in response to a drug that prompts the artery to dilate. This is not currently considered a routine test. Q: Who is at risk for hidden heart disease?A: The risk factors are very similar to those for other types of coronary disease. They include smoking, obesity, high cholesterol, high blood pressure (hypertension), diabetes, sedentary lifestyle and a family history of heart disease. Q: How is hidden heart disease treated?A: Researchers will be studying the best treatments, but we know that with any type of heart disease, it is vital to address your risk factors. That means quitting smoking, maintaining a healthy weight, staying physically active and keeping cholesterol, blood pressure and blood glucose under control. Q: So if I have chest pain, I should take it seriously?A: Definitely! You should take any symptom seriously that could indicate a heart attack. Women are more likely than men to have more atypical symptoms such as: extreme fatigue, indigestion, chest discomfort with lightheadedness, fainting, sweating or shortness of breath. If you have any of these symptoms, call 9-1-1 immediately and chew an aspirin tablet. Even if the symptoms turn out to be something else, it's better to be safe than sorry, and in a heart attack every minute counts. Q: And if I have an angiogram and it turns out clear, I should talk to my doctor about hidden heart disease?A: Yes. Even if you have no symptoms, a "heart-to-heart" talk with your doctor is a wise idea for every woman. Together, you can assess your risk and decide on the best strategy for keeping yourself healthy and heart-disease free.
Want to find a family doctor specially-trained in caring for a woman's heart? Heart Help for Women doctors are educated to recognize a woman's unique risk and symptoms for heart disease.
Call 610-402-CARE to find a doctor. This page last updated 2/12/08 04:08 PM
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