February is the month of love, and it has been aptly chosen as the American Heart Association’s (AHA) Go Red for Women month. The AHA focuses on women because statistics show more women die from heart disease than breast cancer.
Since the campaign began, there’s been a nearly 90 percent increase in awareness among women recognizing heart disease as the leading cause of death. Like men, women’s most common heart attack symptom is chest pain or discomfort. However, women are somewhat more likely than men to experience some ;other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.
Last week, I attended a luncheon where two prominent physicians from Houston Methodist Hospital gave a presentation on congestive heart failure (CHF). The correlation between estrogen and heart health has been known for many years, but it was interesting to learn about the specific alpha and beta estrogen receptors and the interplay between the endocrine and circulatory systems. What’s more, most diagnostic tests don’t differentiate or assess restriction versus constriction in relation to congestive heart failure.
The Journal of the American College of Cardiology published an article that further substantiates differentiating between CHF caused by constriction versus restriction. The authors write:
“Differentiation of constrictive pericarditis (CP) from restrictive cardiomyopathy (RCM) is a complex and often challenging process. Because CP is a potentially curable cause of heart failure and therapeutic options for RCM are limited, distinction of these two conditions is critical.”
For physicians, the first step to correctly distinguishing CHF is appreciating what the diagnostic test covers. Is it evaluation constriction, restriction, or both? For patients, the first step is knowing what questions to ask. What is being evaluated? Are both CP and RCM able to be assessed by the current diagnostic test?
According to the Houston Methodist physicians, not all diagnostic machines have the ability to assess restriction on a Doppler test. Therefore, physicians might be missing an entire half of the equation. The statistics are alarming, but the good news is that the AHA has identified Life’s Simple 7 ways to have a healthy heart: physical activity, healthy diet, maintain a healthy weight, control cholesterol, manage blood pressure, reduce blood sugar, and quit smoking.
Patients should strive to follow these seven rules to reduce their risk of developing CHF. Physicians should discuss and encourage their patients to follow these guidelines, interact with other specialists, ask equipment manufacturers about the diagnostic capabilities, and attend continuing medical education. Combined, we can push the industry forward to better diagnose, detect and prevent CHF. Together, we can have healthy hearts for many Valentine’s Days, and years, to come.
Rachel V. Rose, JD, MBA, advises clients on compliance and transactions in healthcare, cybersecurity, corporate and securities law, while representing plaintiffs in False Claims Act and Dodd-Frank whistleblower cases. She also teaches bioethics at Baylor College of Medicine in Houston. Rachel can be reached through her website, www.rvrose.com.