Sharon Reimold, M.D. Answers Questions On: Heart Disease

Most adults are familiar with the classic image of a patient clutching his or her chest due to the pressure associated with a heart attack, but many are unaware that atypical symptoms of heart problems are just as common – and particularly so in women. In fact, atypical symptoms such as nausea, indigestion, or elbow or jaw discomfort may be the presenting symptoms of coronary artery disease in women. Health care providers must be attuned to the wide variety of presentations and their relationship to gender.

They include tobacco use, hypertension, diabetes, obesity, family history of premature coronary artery disease, and lipid disorders. Interestingly, high triglyceride levels in women are a predictor of coronary artery disease risk, but not in men. And because women have a higher likelihood of a false positive exercise test by electrocardiography, imaging by echocardiography is often helpful in making a diagnosis of coronary artery disease in women and in assessing the risk of subsequent cardiac events.

From my own years of experience in treating cardiovascular disease, I believe statins are useful in helping prevent cardiac events. But in considering statins, a physician needs to determine a patient’s overall risk of cardiac disease and where a cholesterol disorder fits into that risk. In other words, it does no good to simply lower someone’s cholesterol but leave their blood pressure high. If cholesterol-lowering strategies are in order, statins aren’t the only option. Diet, exercise, and even natural solutions can be effective. Physicians and patients should discuss these options so everyone is comfortable with the decision.