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Women and Coronary Artery Disease (CAD)

Women and Coronary Artery Disease (CAD). Module 4 Patient Education. Supported by an unrestricted educational grant from Fujisawa Healthcare, Inc. Overview of Heart Disease. How Do I Know I Have Heart Disease?. What Is Cardiovascular Disease (CVD)?. Diseases of the heart and blood vessels:

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Women and Coronary Artery Disease (CAD)

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  1. Women andCoronary Artery Disease (CAD) Module 4Patient Education

  2. Supported by an unrestricted educational grant from Fujisawa Healthcare, Inc.

  3. Overview of Heart Disease How Do I Know I Have Heart Disease?

  4. What Is Cardiovascular Disease (CVD)? • Diseases of the heart and blood vessels: • Heart disease • Myocardial Infarction (heart attack) • Angina (chest pain or discomfort caused by reduced blood supply to the heart muscle) • Stroke • High blood pressure

  5. Blood Flow Squeezing Heart Artery Heart Moving & Functioning Body Why Are Arteries in the Heart Important?

  6. What Is Heart Disease? Plaque builds up inside my arteries, decreasing blood flow to my heart Decreasing blood flow Normal heart artery Minimal heart disease Moderate heart disease Severe heart disease Glagov S, et al. N Engl J Med. 1987

  7. In a person with heart disease, one or more of the coronary arteries has been narrowed or blocked by a buildup of fatty deposits. This reduces "myocardial perfusion," which is the amount of blood flowing into the heart muscle. If the blood flow is reduced too much, part of the heart muscle is injured, causing a heart attack. The injured part of the heart muscle can be permanently damaged. Heart disease occurs when arteries supplying blood to the heart muscle become narrowed or blocked Every muscle in your body needs a constant flow of blood to stay healthy. Your heart is a muscle, too (called the myocardium). So, in addition to the blood that goes through your heart as it pumps, blood is carried into the heart muscle itself by a network of coronary arteries. This flow of blood supplies your heart muscle with oxygen and nutrients. How Heart Disease Happens

  8. Part of the Heart Muscle Dies What Is a Heart Attack? Blood supply is blocked • When blood supply to my heart muscle is severely reduced or stopped • Heart attack/coronary/myocardial infarction • Reduced blood flow is caused by a buildup of plaque (or fatty deposits) in the heart’s arteries. • Buildup damages the arteries, causing clots to form, blocking blood supply • If the blood supply is cut off for more than a few minutes, muscle cells suffer permanent injury and die, which can kill or disable someone depending on how much heart muscle is damaged Leaving the heart muscle weaker and less able to pump blood to the body

  9. What Are Common Symptoms of Heart Disease? • Shortness of breath • Fatigue • Chest discomfort or pain that can spread to the arms, neck, back, or jaw • Symptoms can occur during activity or stress • Many women with heart disease experience no symptoms at all

  10. What Tests Are Available?

  11. Electrocardiogram (ECG or EKG) • Graphic record of the electrical activity of the heart as it contracts and rests • Electrodes are placed on your arms, legs, and chest • Abnormal heartbeats, some areas of damage, inadequate blood flow, and heart enlargement can be detected • Performed while you are resting or exercising (called a “stress test”)

  12. Stress Test • A stress test is a “work out” for your heart • Also called a “treadmill test” or “exercise test” • You walk on a treadmill • Start at a relatively slow pace • Speed and grade increase every few minutes • When you have fatigued or reached the maximum amount of work you can do, the test will stop

  13. What If I Am Unable to Exerciseon a Treadmill? • If you cannot exercise on a treadmill, your doctor may give you a drug that has an effect on your heart similar to exercise • This is called a “pharmacologic stress test” • The drug is infused through an IV tube into your arm

  14. Stress Test With Imaging • Sometimes additional imaging tests are performed during your stress test: • Nuclear imaging • Echocardiography

  15. Nuclear Imaging • Also called “nuclear scan” or “perfusion imaging” • Small amount of radiation (“tracer”) is injected into your bloodstream • The radiation level is the same as a day at the beach • A special camera takes pictures of your heart • Images can show damage to heart muscle and blood flow problems

  16. Echocardiography • Small device called a transducer moved around your chest to image your heart • Transducer uses ultrasound waves to generate images • Images give information on heart muscle, valves, chambers, and major blood vessels

  17. Magnetic Resonance Imaging (MRI) • Uses strong magnets to detect energy signals from your heart • Produces clear 3-D images of your heart • Mostly investigational use at present time

  18. Electron Beam Computed Tomography • Also called “ultrafast CT” or “heart scan” • Detects coronary calcium levels (a marker for coronary artery disease) • Electron beams produce 3-D views of your heart • A dye is sometimes injected to help visualize coronary arteries and veins

  19. What if My Stress Test or Imaging Tests Are Abnormal? • Your doctor may order a cardiac catheterization (also called “angiography”) • Afterward, your doctor will show you any blockages in your 3 major heart arteries

  20. Angiography • A long, thin tube is inserted through your arm or leg artery into your heart • Dye is sent through a catheter into your arteries • The movement of dye helps visualize any blockages • Compared with noninvasive imaging, angiography is more invasive and relatively expensive

  21. Treatment for Heart Disease

  22. Treatment for Heart Disease • Lifestyle changes • Low-fat diet • Appropriate exercise • Quitting smoking • Medications • Surgical treatment

  23. Lifestyle Changes • Low-fat diet • A low-fat (low saturated fat) and low-cholesterol diet will help reduce high cholesterol, a primary cause of heart disease • If you are overweight, losing weight can help lower cholesterol and high blood pressure • Appropriate exercise • Moderate amounts of physical activity are associated with lower death rates from heart disease • If you have severe heart disease, you may have to restrict your exercise somewhat • Quitting smoking • Dramatically lowers the risk of a heart attack

  24. Medications • Different drugs work in different ways to help improve the functioning of your heart • Digoxin, nitroglycerine, aspirin, diuretics, ACE inhibitors, beta-blockers, etc • Other medications can help control conditions contributing to your heart disease • Drugs to lower cholesterol (“statins”) or blood pressure

  25. Coronary artery bypass surgery (CABG) Bypass Blood Flow Artery Mechanically Open Stent and/or balloon angioplasty Surgical Treatment

  26. Conclusions • Know the symptoms of heart disease • Know your risk factors for heart disease • Visit your healthcare provider • Discuss your risk factors • Ask questions about your heart tests • Maintain a healthy lifestyle

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