Ischemic Heart Disease and Women: Diagnosis Is Not One-Size-Fits-All  

An exercise stress test looks for the obstruction of oxygen en route to the heart. This is obstruction is called ischemia. But it’s not the same for everyone.

Women—and some men—may appear to have clear arteries, making their ischemic heart disease hard to detect from an exercise stress test.

Ischemia Is Common, But It’s Also Serious

As we breathe, we take oxygen into the lungs. It then travels through the blood vessels—unless obstructed.

Medical science has long understood that obstructions can result from blood clots or from atherosclerosis, which occurs when “bad” cholesterol hardens and clogs the arteries.

The problem with an obstruction is the way it can prompt serious health events. These can involve leg problems, intestinal diseases, strokes and heart attacks.

Ischemia May Have Particular Effects in Women

Some women see a doctor on account of chest pain, but are not up to the exertion needed to get a meaningful result on an exercise test. And if the test does show an issue, the follow-up angiogram might show no blockage.

Therefore, many women have missed out on vital medical or diet advice. Today, we know there’s a type of heart disease that cannot be noticed on angiograms. Nearly five times as many false-positive stress tests occur in women as in men.

This is just one reason that leads us to do more than apply one blanket approach to diagnosing ischemia.

Leading-edge studies from the Women’s Ischemia Syndrome Evaluation (WISE) study show:

  • Plaque can obstruct blood flow around—rather than inside—the artery.
  • Plaque, especially in women, can accumulate in small blood vessels that don’t show up on the angiogram.
  • Tightness or pain in the chest is not always connected with plaque buildup.
  • Estrogen may change how the coronary arteries’ lining reacts to plaque and to stress.

Ischemia Might Have No Symptoms—But Sometimes the Body Sends Signals.

If you do have symptoms, see a doctor promptly. Symptoms may involve:

  • A racing heart.
  • Pain, numbness, or inability to move in any part of your body, from your jaw down through an arm, or in your feet or legs.
  • Fatigue, or being easily winded during exercise.
  • Unusually heavy perspiration.
  • An upset stomach or the runs.
  • Pain or tightness in your chest when carrying things, climbing stairs, or dealing with stressful situations.

Symptoms that may indicate an obstruction in the brain include sudden headaches, accompanied by nausea, dizziness, or fainting. Perhaps you can’t understand what people are saying, or you’re having trouble speaking. Shiny skin on your feet and legs can also be a warning.

To consult with an ischemic heart disease expert, call (718) 283-8902—or request an appointment with one of our specialists online.

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