Ischemic heart disease is the most common type of heart disease worldwide, and it is often missed in female patients
1 February 2022| Last updated on 11 February 2022
Cardiovascular disease is the leading cause of death worldwide, according to the World Health Organisation (WHO).
The most common heart disease that affects people is called ischemic heart disease. A common misconception is that ischemic heart disease is a disease of men. Although it is true that currently, the majority of ischemic heart patients are male, it is also very common for women to suffer from ischemic heart disease.
In fact, in developed countries, ischemic heart disease is the most common cause of death in women.
Sadly, ischemic heart disease is often missed in women.
Dr. Liza Wong, Consultant Cardiologist at Mediclinic Deira and Mediclinic Welcare Hospital, shares her expertise about this particular disease and how to boost heart health.
What is ischemic heart disease?
Ischemic heart disease is a condition where the heart does not receive enough blood and oxygen due to a coronary blockage.
A coronary blockage is a narrowed blood vessel that provides blood and oxygen to the heart muscle. This process of narrowing is called atherosclerosis and happens due to fatty depositions on the inside of blood vessels.
What are the symptoms of ischemic heart disease?
The most common symptom of ischemic heart disease is chest pain, sometimes radiating to the left arm, shoulder or jaws.
In addition, people might feel:
- Shortness of breath
- Profuse sweating
- Nausea or vomiting.
Not everybody has the same symptoms and as mentioned, women less often have chest pain as a presenting symptom compared to men.
What are the risk factors for ischemic heart disease?
The classical risk factors for ischemic heart disease are:
- Hypertension (high blood pressure)
- Hypercholesterolemia (high cholesterol)
- Use of tobacco
- Having a sedentary lifestyle.
How to reduce the risk of heart disease
The risk of acquiring cardiovascular disease can be reduced significantly by modifying these risk factors through adopting a healthy lifestyle. Maintaining healthy body weight, exercising regularly, cessation of tobacco use and following a healthy diet can improve a person’s blood pressure and sugar and lipid levels tremendously.
The American Heart Association recommends that healthy adults check their cholesterol levels and other cardiovascular risk factors once every 4-6 years.
Furthermore, a healthy weight should reflect in a BMI between 18 and 25 kg/m2. With regards to exercise, it is recommended to commit to at least 75 minutes of strenuous exercise, or 150 minutes of moderate level exercise every week.
Even with all modern technology and treatments, prevention of heart disease is still the key and it is paramount to live a healthy lifestyle to ensure our best chances of growing old healthy.
Why is ischemic heart disease often missed in women?
"This has several reasons," said Dr. Liza.
"First, because people believe that ischemic heart disease is a disease of men, both doctors and female patients themselves are less prone to suspect ischemic heart disease, leading to delays in visiting the doctor and delays in the diagnostic process," she explained.
Secondly, whereas the most common symptom of ischemic heart disease is chest pain in both men and women, women do tend to have other presenting symptoms of ischemic heart disease more frequently, such as shortness of breath, fatigue, nausea, or palpitations. Because the presenting symptoms of women are more varied and less typical than those of men, women are more often misdiagnosed.
She added: "Also, women display a different pattern of atherosclerosis. Where men tend to have coronary blockages in the larger parts of the coronary arteries, women more often have blockages in the small blood vessels of the heart, called microvascular ischemic heart disease."
Microvascular ischemic heart disease can cause exactly the same symptoms as coronary blockages in the larger parts of the coronary arteries, but is not visible on the diagnostic tests that exist for diagnosing coronary blockages.
So, if after examination the large coronary arteries don’t show blockages, women are often told their complaints are not caused by ischemic heart disease and subsequently, they are wrongfully not being treated for it.
Scientific reports have established that even if ischemic heart disease is diagnosed beyond any doubt, women are treated less optimally than men. For example, the necessary mediation for ischemic heart disease is more frequently not being prescribed to women compared to men, sometimes out of fear for side effects from both the doctors’ and the patient’s side.
"Obviously, it’s very important to treat both women and men in the most optimal way for their heart disease," said Dr. Liza.