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Medical News Today: Heart health: Are women getting incorrect treatment?

Recent research suggests that ignoring sex-specific risk factors of heart disease has resulted in women having a higher risk of dying from heart failure than men.

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Differences between men and women may mean that the latter do not receive the right treatment for heart conditions.

A review published in Nature Medicine reveals an alarming failure to successfully treat cardiometabolic disorders, such as diabetes, heart disease, and stroke, in women.

The authors urge health services to consider the biological differences between men and women when treating heart disease.

The review, by Prof. Eva Gerdts, of the University of Bergen, in Norway, and Prof. Vera Regitz-Zagrosek, of the Charité Universitätsmedizin Berlin, in Germany, compares the common risk factors for both sexes.

"Men and women have different biologies, and this results in different types of the same heart diseases. It is about time to recognize these differences."

Prof. Eva Gerdts

The authors summarize the results of over 18 major studies that have explored the causal factors of heart disease in each sex.
The overwhelming finding was that women are more at risk of receiving the wrong treatment because health service professionals fail to spot symptoms or risk factors that are unique to women.

Obesity at the heart of it

Recent research has substantiated fears that the global rise in cardiometabolic disorders is linked to obesity. Meanwhile, fresh evidence suggests that obesity and associated damage to the heart occur differently in men and women.

Global figures show that obesity in women is on the rise, and as Prof. Gerdts' review explains, women store fat differently from men. The mechanisms behind this process combine to create an increased risk of type 2 diabetes and heart disease.

"If we see this from a life span perspective, we can see that obesity increases with age and that this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease," explains Prof. Gerdts.

The estrogen advantage

The hormone estrogen works to impede metabolic syndrome by preventing connective tissue from forming in the heart. This also helps keep blood pressure stable.

But the decrease in estrogen that occurs during menopause can increase the risk of arterial stiffening and subsequent disease.
This helps explain an increase in hypertension among women over 60. In men, meanwhile, hypertension is more common before the age of 60.

Lifestyle risks increase with age

Socioeconomic status and lifestyle factors also play a role in cardiovascular risk discrepancies.
The researchers highlight the fact that, around the world, women are more likely to experience low levels of education, low income, and joblessness, and that studies have associated each of these factors with diabetes and depression — two major contributing factors for heart disease.

Meanwhile, the adverse effects of unhealthful habits, such as smoking — which is on the rise in women — multiply as we age. This can lead to high blood pressure, which can cause heart failure if a person does not receive treatment.

"For women, the effects of risk factors such as smoking, obesity, and high blood pressure increase after menopause," says Prof. Gerdts.

What can we do?

Prof. Gerdts hopes to incite action among the medical community; she calls for healthcare providers to place more emphasis on sex differences when treating cardiometabolic disorders.

"Heart disease remains among the most common cause of death and reduced quality of life in women. Medically speaking, we still do not know what the best treatment for heart attack or [heart] failure is in many women. It is an unacceptable situation."

Prof. Eva Gerdts

The present study highlights an imbalance in available research, in an effort to pave the way for further work.

The outlook is promising if we consider that cardiac arrest — which is more common in men — is now treatable and preventable. If the same resources and research were applied to the factors that put women at risk of heart failure, perhaps similarly effective interventions could be developed in the near future.

In the meantime, it is important for healthcare providers to help women in high-risk groups lower their blood pressure, reduce the risk or effects of obesity, and put quitting smoking at the top of their list of 2020 goals, if necessary.

Original Article

Medical News Today: Cardiomyopathy: What to know

Cardiomyopathy is a disease that involves a weakened heart muscle. The condition makes it difficult for the heart to pump blood throughout the body.

According to the Centers for Disease Control and Prevention (CDC), cardiomyopathy may occur in as many as 1 in 500 people, but it frequently goes undiagnosed. Cardiomyopathy can develop over time, or a person may have the disease from birth.

Keep reading to learn more about cardiomyopathy, including its symptoms, causes, and treatment.

Types

There are a few types of cardiomyopathy, including the following:

Dilated

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A person with cardiomyopathy may experience shortness of breath and heart palpitations.

Dilated cardiomyopathy is the most common form of the disease. It typically occurs in adults between the ages of 20 and 60 years.

The disease often starts in the left ventricle, but it can eventually also affect the right ventricle.

Dilated cardiomyopathy can affect the structure and function of the atria, too.

Hypertrophic

Hypertrophic cardiomyopathy is a genetic condition in which abnormal growth of the heart muscle fibers occurs, leading to the thickening or "hypertrophy" of these fibers. The thickening makes the chambers of the heart stiff and affects blood flow. It can also increase the risk of electrical disturbances, called arrhythmias.

According to the Children's Cardiomyopathy Foundation, it is the second most common form of cardiomyopathy in children. In about one-third of affected children, diagnosis occurs before the age of 1 year.

Restrictive

Restrictive cardiomyopathy occurs when the tissues of the ventricles become rigid and cannot fill with blood properly. Eventually, it may lead to heart failure. It is more common in older adults and can result from infiltrative conditions — those involving the accumulation of abnormal substances in bodily tissues — such as amyloidosis.

Arrhythmogenic

In arrhythmogenic cardiomyopathy, fibrotic and fatty tissue replaces the healthy tissues of the right ventricle, which may cause irregular heart rhythms. In some cases, this process can also occur in the left ventricle.

According to research in the journal Circulation Research, arrhythmogenic cardiomyopathy increases the risk of sudden cardiac death, especially in young people and athletes. It is a hereditary genetic condition.

Learn more about some other types of heart disease here.

Symptoms

In some cases, usually mild ones, there are no symptoms of cardiomyopathy.

However, as the condition progresses, a person may experience the following symptoms with varying degrees of severity:

  • fatigue
  • shortness of breath
  • swelling of the legs and ankles
  • heart palpitations
  • dizziness
  • fainting

Causes and risk factors

The cause of cardiomyopathy is not always clear, but there are some known risk factors.

For example, conditions that lead to inflammation or damage of the heart can increase a person's risk of cardiomyopathy.

Heart failure, which can occur as a result of a heart attack or other conditions, can also cause cardiomyopathy.

Additional risk factors include:

Diagnosis

Doctors will carry out a physical exam and diagnostic tests to confirm cardiomyopathy.

They are likely to use one or more of the following diagnostic tests:

  • Chest X-ray: A chest X-ray helps determine whether the heart has become enlarged, which is a sign of certain health conditions.
  • Electrocardiogram (EKG): An EKG measures the electrical activity of the heart, including how fast it is beating. It also shows whether the heart rhythm is regular or abnormal.
  • Echocardiogram: An echo uses sound waves to create a moving image of the heart. It shows the shape and size of the heart.
  • Cardiac catheterization: A catheterization checks the flow of blood through the heart's chambers.

Treatment

The intention of cardiomyopathy treatment is to control symptoms, slow the progression of the condition, and prevent sudden cardiac death. The type of treatment may depend on the severity of the symptoms and the form of cardiomyopathy.

Usually, treatment includes a combination of the following:

Lifestyle changes

Lifestyle changes can help reduce the severity of conditions that may have led to cardiomyopathy. More healthful lifestyle habits may also slow the progression of the disease.

Lifestyle changes may include following a healthful diet, which involves limiting the intake of trans fats, saturated fats, added sugar, and salt.

Read about 16 foods for a healthy heart here.

Managing stress, quitting smoking, and staying physically active are also beneficial for people with cardiomyopathy.

The quantity and intensity of beneficial physical activity may vary. It is essential to discuss exercise programs with a doctor or another healthcare professional before starting one.

Medications

Usually, medications are part of a cardiomyopathy treatment plan. Some types of drugs that doctors may prescribe include:

  • Beta-blockers: Beta-blockers slow the heart rate, meaning that the heart has to work less hard.
  • Blood thinners: Blood thinners help decrease the risk of blood clots developing.
  • Diuretics: Diuretics remove excess fluid from the body. This fluid may accumulate when the heart does not pump efficiently.
  • Blood pressure drugs: Angiotensin converting enzyme (ACE) inhibitors, angiotensin receptor blockers, and angiotensin receptor-neprilysin inhibitors help lower blood pressure and interrupt the stress receptors that become activated in people with cardiomyopathy.
  • Antiarrhythmics: Antiarrhythmics are medications that prevent abnormal heart rhythms.

Implanted devices

Treatment may also include different types of implanted devices. The specific device depends on the symptoms. Implanted devices include:

  • Pacemaker: After its surgical implantation beneath the skin near the chest, a pacemaker delivers electrical impulses to the heart, causing it to beat at a normal rate.
  • Implantable cardioverter-defibrillator: This device also delivers an electric shock to the heart when it detects an abnormal, potentially unstable heart rhythm. The electrical impulse returns the heart rhythm to normal.
  • Left ventricle assist device (LVAD): The LVAD assists the heart in pumping blood throughout the body. When cardiomyopathy has severely weakened the heart, this device is helpful while a person is waiting for a heart transplant.
  • Cardiac resynchronization device: This implanted device helps coordinate the contractions of the left and right ventricles of the heart to improve heart function.

Surgery

When symptoms are severe, surgery might be an option. Some possible surgical procedures for cardiomyopathy include:

Septal myectomy

This surgery treats hypertrophic cardiomyopathy with obstruction of blood flow. It involves removing part of the septum that is protruding into the left ventricle. Removing the thickened tissue improves blood flow out of the heart.

Heart transplant

People with certain forms of cardiomyopathy with advanced heart failure might be eligible for heart transplantation. However, a heart transplant is an extensive process for which not everyone qualifies.

When to see a doctor

Cardiomyopathy is a serious medical condition that requires treatment.

Without treatment, the disease may progress and become life threatening.

Anyone who has a strong family history of cardiomyopathy or experiences one or more of the symptoms of this disease should see a doctor. An earlier diagnosis may improve a person's outlook.

Summary

Cardiomyopathy is a disease that involves the weakening of the heart muscle.

There are various forms of cardiomyopathy, including dilated cardiomyopathy, which is the most common.

Treatment for cardiomyopathy depends on the extent of the symptoms, as well as the form of the disease.

Treatment usually consists of lifestyle changes and medications. Additional treatment in more severe cases may include implanted devices or surgery.

Original Article

Medical News Today: Chest pain and leg pain: Are they connected?

Leg pain and chest pain do not typically occur together. However, there is a connection between leg pain and heart health, so a person may experience both of these symptoms at the same time.

If a person is experiencing chest pain, they should seek medical attention immediately as it may indicate a heart attack.

In this article, we explore the link between leg pain and heart health. We also look at diagnosis, treatment, and when to seek help.

Peripheral artery disease

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A person with PAD may experience leg pain.

Sometimes, leg pain can indicate that a person is at risk of developing heart disease.

Peripheral artery disease (PAD) occurs when the peripheral arteries become narrow, and fatty deposits start to build up.

According to the findings of a 2014 study, people with PAD have a higher lifetime risk of dying from a cardiovascular event.

The most common symptom of PAD is painful muscle cramps in the thighs, hips, or calves when a person is exercising, walking, or climbing stairs.

Other symptoms include:

  • poor nail growth
  • erectile dysfunction
  • a decrease in temperature in the lower leg or feet
  • wounds on the feet or toes that heal slowly

Pain after cardiac surgery

It is normal to experience pain after cardiac surgery. Sometimes, people also report experiencing leg pain after cardiac surgery. This pain usually occurs if surgeons take a vein graft from the leg.

According to researchers, moderate-to-severe chronic pain still affects 11.8% of people 12 months after cardiac surgery.

While pain following cardiac surgery is typical, a person should talk to a doctor if the pain seems to be getting worse instead of better over time, or if it remains severe.

Diagnosis

A doctor will consider all of a person's symptoms when diagnosing potential causes of pain.

If a person is experiencing significant levels of pain after surgery, and the pain is persistent, they should talk to a doctor.

They should also talk to a doctor if they experience symptoms of infection after surgery, such as warmth, redness, swelling, or drainage from the incision sites.

PAD

Doctors will diagnose PAD by carrying out a physical examination, which may include:

  • Ankle-brachial index test: Blood pressure measurements in the arm and ankle can indicate potential blockages.
  • Doppler and ultrasound imaging: This method shows the arteries using sound waves and measures the flow of the blood.
  • Imaging studies of the heart's blood vessels: These include CT scans and angiography.

Chest pain

If a person is experiencing chest pain, a doctor will first try to establish whether they have had a heart attack.

A doctor may perform a variety of tests to diagnose a heart attack, including:

  • electrocardiogram (EKG)
  • X-ray
  • echocardiogram
  • CT scan
  • exercise stress test

A doctor may also take blood tests to check whether the levels of certain enzymes that indicate that the heart is under stress have become elevated.

Learn more about the possible causes of chest pain here.

Treatment and prevention

The type of treatment for chest and leg pain will depend on the underlying cause.

PAD

Treatment for PAD tends to focus on preventing the disease from progressing and reducing the symptoms.

People can help prevent and treat PAD by:

Pain after cardiac surgery

As pain after surgery might affect a person's recovery, the doctor may prescribe a combination of pain relievers, including opioids and nonsteroidal anti-inflammatory drugs (NSAIDS).

A doctor may also use other treatment methods, such as transcutaneous electrical nerve stimulation and regional anesthesia.

If a person has developed an infection at the surgical site, a doctor may prescribe antibiotics after cleaning the wound.

Chest pain

If a person has experienced a heart attack, a doctor may consider a variety of treatments, including:

When to seek help

People experiencing chest pain, leg pain, or both should speak to a doctor in the following situations.

PAD

A person should see a doctor if they experience any symptoms of PAD.

According to the National Heart, Lung, and Blood Institute, even if a person is not experiencing symptoms of PAD, they should still see a doctor if they are:

  • under 50 years of age and have diabetes and one or more risk factors for atherosclerosis, which include high blood pressure and obesity
  • are aged 50 years or older and have a history of diabetes or smoking
  • are aged 70 years or older

Pain after cardiac surgery

A person should see a doctor if they are experiencing symptoms of infection following cardiac surgery, or if the pain does not lessen.

Heart attack

New-onset chest pain is almost always a concerning symptom, and a person should not ignore it. If they experience chest pain, they should seek emergency medical attention.

The symptoms of a heart attack can vary among individuals, but a person may experience:

  • pressure or pain in the chest or upper portion of the stomach
  • nausea
  • pain in the arms, back, or stomach that can go downward
  • shortness of breath
  • unexplained and extreme fatigue
  • vomiting

Summary

Chest pain and leg pain are two symptoms that do not typically appear together. However, they can co-occur if a surgeon takes a vein graft from a person's leg as part of cardiac surgery or if a person has peripheral artery disease.

A person should see a doctor if they have chest pain or persistent or severe leg pain.

Even if a person is not experiencing a cardiac event, they may require medical treatment to reduce their symptoms and prevent the likelihood of their medical condition worsening.

Original Article