Women Take Risk of Disease to Heart
By Tom Corwin< Staff Writer
Lena Jordan is a perfect example of the problems women have with heart disease and how technology is coming to their aid.
Today is National Wear Red Day to help spread awareness about women and heart disease, the No. 1 cause of death and one that kills more women than the next four causes of death combined, according to the American Heart Association.
Mrs. Jordan, 61, didn’t think she was at risk for heart disease even though her father died of a heart attack around age 40.
Lately, she would lie down to sleep and “I couldn’t catch my breath,” she said. Her husband said, “I’m carrying you to the doctor for that cold.”
It turned out to be a blockage in an artery near her heart. Fortunately for Mrs. Jordan, doctors at the Medical College of Georgia Hospital and Clinics on Wednesday decided to use intravascular ultrasound, a probe slipped over the usual cardiac catheterization wire, to get a closer look.
“We had a blockage in one of the arteries, and we thought it was too small to put a stent in,” said MCG cardiologist Molly Szerlip, who was observing the procedure.
A stent is a wire mesh coil that is usually used after balloon angioplasty to keep the vessel open.
“We used (the ultrasound) and found that the artery was actually quite big. And we put a stent in and got a wonderful result.”
The ultrasound technology is not really new, but some are still reluctant to use it, said Les Walters of the Augusta Cardiology Clinic. He employs it on roughly half of his cases, and it is particularly helpful with women patients. The intravascular ultrasound can help the cardiologist get the right size stent and help ensure that it is fully expanded inside the vessel and covering all of the area it should, Dr. Walters said.
“The average woman, her vessels tend to be a little smaller, so you want to make sure you’ve got that stent properly expanded and the right size,” he said. Generally, the larger the stent, the less chance of it closing off later. Having that extra information – not only about how it looks but the extent of the plaque and the composition of it – helps fine-tune the diagnosis, Dr. Walters said.
“It cuts down the mistakes. This tells me, yes, I can still go further, safely,” he said.
And that can mean better long-term results.
But Mrs. Jordan’s case also illustrates an ongoing problem for women, one that has been lamented for years – their symptoms are just not taken seriously, Dr. Szerlip said. Particularly when it is not a heart attack but more subtle signs of a blockage, known as angina, she said.
“They could just be fatigued, weak, haven’t been able to sleep for the last couple of nights or even the last month,” Dr. Szerlip said.
It could even be back pain or just pressure in the chest, she said.
“These aren’t classic signs as we know it of angina, but it is becoming classic signs for women with angina,” Dr. Szerlip said.
Some women may not have blockages at all but a condition known as endothelial dysfunction, in which the blood vessels lose the ability to dilate and are narrowed. That leaves them at five times greater risk of dying of a heart attack in the next five years, Dr. Szerlip said. The treatment involves reducing their risk factors – such as smoking, obesity and high cholesterol – but the condition might not be recognized as heart disease and treated aggressively, she said.
“If they’re not identified early on as having that, then they don’t get treated for it,” Dr. Szerlip said.
Reach Tom Corwin at (706) 823-3213 or tom.corwin@augustachronicle.com.
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