Women and Heart Disease Lecture Powerpoint

Question 1

Women are unique in that they often exhibit what unusual symptoms of acute myocardial infarction/cardiovascular disease (4)

Answer 1

• Fatigue
• Upper abdominal pain or burning sensation
• Shortness of breath
• Can be precipitated by rest or sleep

Question 2

What rate of women die from breast cancer? From heart disease?

Answer 2

1/36, 1/3

Question 3

Female breast cancer deaths have continued to ___ while heart disease deaths have ____ over the years

Answer 3

decrease, increased

Question 4

Diastolic heart failure (what gender is it more common in and definition of disease)

Answer 4

• More common in women than men
• a process due to aging, caused by thickened stiff heart muscle in ventricles that is common in advanced age with HTN history

Question 5

Pre vs Post menopausal likelihood of death by acute MI

Answer 5

1 in 17 pre and 1 in 2.5 post

Question 6

Death rate from CVD and cancer is more common in what race of females and why?

Answer 6

White, often have increased trouble quitting smoking

Question 7

Which gender is more likely to have a second heart attack within first 6 years of first and why?

Answer 7

Women, they tend to not change behaviors following MI to same degree as men

Question 8

Risk factor calculator for CVD

Answer 8

A formula that determines thru a combo of gender, age, family history, and modifiable risk factors such as obesity, smoking, and lack of exercise the likelihood of being at risk for CVD

Question 9

Female smokers go thru ____ earlier than their non smoking counterparts

Answer 9

Menopause (now their risk for heart disease increases earlier in life due to drop in estrogens –> drop in cardioprotective HDL)

Question 10

Desired hip to waist ratio to minimize cardiovascular disease in women, what is the desired BMI?

Answer 10

less than .8, less than 25

Question 11

___shaped women are at greater risk for CVD than ___ shaped women

Answer 11

apple, pear

Question 12

Estrogen replacement therapy for reducing risk of heart disease in females

Answer 12

NOT recommended for solely reducing risk, instead recommended to change modifiable risk factors

Question 13

Common causes of 2ndary hypertension in females (5)

Answer 13

• PCOS
• Renal artery stenosis
• aortic coarctation
• Cushing’s syndrome
• OCP usage > 5 years (rare)

Question 14

Compared to men, women with heart failure have these characteristics (4)

Answer 14

• older
• more likely to have hypertension
• more likely to have diabetes
• more likely to have diastolic dysfunction

Question 15

2 types of chest pain more common in women and what are the conditions associated with them called, and what vasculature do they effect?

Answer 15

1) vasospastic angina (prinzmetal’s, effects epicardial vessels)
2) microvascular angina (cardiac syndrome X, effects vessels all over heart)

Question 16

Vasospastic angina (prinzmetal’s) in women, diagnostic findings, and treatments (3)

Answer 16

• Vasoconstriction or spasm of epicardial coronary arteries that causes pain at rest often in women common in heavy smokers
• present with elevated ST segment during episode, does not have troponin elevation, has normal angiogram
• nitroglycerin and Ca2+ channel blockers while daily aspirin makes it worse

Question 17

Microvascular angina (cardiac syndrome X) and how is it diagnosed?

Answer 17

• Abnormal vasoreactivity of coronary microvessels, sees chest pain and ischemic response to stress testing, very symptomatic and difficult to treat
• Diagnosed by combining treadmill testing with nuclear imaging or exercise echocardiography

Question 18

Drawbacks to diagnostic imaging in women (2)

Answer 18

• Lower exercise capacity decreases likelihood of reaching dequate pressure rate product
• breast attenuation artifact leads to higher false positive imaging studies

Question 19

Women at high or intermediate risk of coronary artery disease should undergo this set of tests and this alternative set if they cannot exercise

Answer 19

• treadmill echocardiogarphy or nuclear perfusion imaging

- dobutamine stress echocardiography or adenosine nuclear imaging

Question 20

Takesubo’s cardiomyopathy and treatment options

Answer 20

• Mimic’s acute coronary syndrome, characterized by left ventricular apical ballooning, presents with absence of angiographically significant coronary artery stenosis and is typically precipitated by acute emotional distress (also known as broken heart syndrome)
• Treated with ACE inhibitors, B blockers, aspirin and a statin