Caitlin Whyte (Host): Welcome to another episode of Memorial Health Radio with Memorial Health System, Ohio. Today, we're delving into an important and often overlooked topic. Women's heart health. Joining us for this conversation is Jessica Slavin an Acute Care Nurse Practitioner in Cardiology.

Now, Jessica, women do not typically experience the same symptoms as men when it comes to having heart attacks, with many not even experiencing any sort of chest pain. So what are some warning signs or signals that women should be aware of?

Jessica Slavin, NP: Sure. I think that women seem to downplay their symptoms at times or relate it to other things that they may be struggling with with their health; anxiety being one, GI upset or abdominal discomfort, breaking out into a sweat, that they would potentially relate to hormonal changes.

Nausea and lightheadedness or feeling extremely fatigued for no cause.

Host: Gotcha. Great. Some things to look out for indeed. Well, are there certain risks for heart attacks or heart disease that may be higher for women than men?

Jessica Slavin, NP: Absolutely, I think that our women's sex hormones, mostly our estrogen, play a significant role in women's heart health. Emerging risk factors, like autoimmune diseases such as lupus, rheumatoid arthritis, gestational diabetes. You know, being pregnant alone obviously increases our risk for different cardiovascular diseases, pregnancy induced hypertension, early menopause, either natural or surgical, in relation to menopause and depression all show a two to three fold higher risk for ischemic heart disease.

Host: Could you expand on how a woman's hormonal health plays a role in their heart health?

Jessica Slavin, NP: Yeah, absolutely. Menopause, marks actually the biggest cardiovascular biological risk factor, due to our estrogen loss, having a negative effect on our arterial function and adversely altering our cholesterol profiles. Whenever you hit menopause, your lipid profile can be altered and it can be significantly harder to maintain a woman's healthy lipid profile with statins or other drugs that are on the market.

 You may have to go to a higher degree of coverage on your lipids, on your lipid profile, to get women at goal.

Host: Good to know. Well, do certain conditions such as diabetes or high blood pressure impact women differently in terms of their heart health?

Jessica Slavin, NP: Absolutely. I think this is actually, one of my favorite questions whenever I was reviewing, the questions that you'd provided, and I think it's just something that health care providers don't always diagnose or we kind of talk around it, but it's metabolic syndrome. Especially when women, hit that age of menopause, it puts us at higher risk for, metabolic syndrome because our metabolisms slow down, our waist circumference increases, we get that truncal obesity, our insulin resistance changes, and we gain weight. Women are unfortunately, known to have a higher prevalence of inactivity. And inactivity meaning like true intentional workouts, like doesn't mean we're not active.

We're busy. We're, busy people. We're maintaining the family functions, the schedules, all the things, but we don't set aside that allotted time for our true physical activity, and those statistics show that 25 percent of U.S. women get no regular physical activity, and that alone increases our risk of sudden cardiac death.

Well, what advice would you offer to someone who suspects that they may be experiencing a heart attack? Obviously, seek medical treatment. I think, again, with women, we can be a little bit vague in our subjective description of our chest pain complaints, and if you can seek medical attention early and give as many details as you can about your complaints, that would help healthcare providers.

Typically, whenever you present to the emergency room, with complaints of chest pain or even atypical complaints of chest pain, they would, should be triggered to use a heart score. It's an algorithm used in treatment management, and it uses your history and EKG, age, traditional risk factors and troponin criteria, but that screening tool alone doesn't take into consideration specifically women's health history.

So just be as specific as you can whenever you come in with the complaints, because it could definitely be missed or undiagnosed if you don't give that detailed history.

Host: Well, let's talk about lifestyle changes. What advice would you offer a woman who is looking to improve her heart health and reduce her risk of heart attack or heart disease through some lifestyle changes?

Jessica Slavin, NP: Sure. I think this is my second favorite question. All of my colleagues know me well enough, my friends know me well enough. Anyone that follows me even on social media, I definitely practice what I preach and that is a minimum of 30 minutes of intentional movement a day. I have a Peloton bike, so I'm on my Peloton, pretty regularly during the week.

 Obviously that's not something that you need to go out and purchase by any means, but walking 30 minutes a day, brisk walking. I know the American Heart Association says that a minimum of 150 minutes a week of brisk activity or 75 minutes of vigorous activity a week does help women reduce their risk of heart attack and heart disease.

So just being intentional with your movement. With a generation that no matter how old you are, we typically have cell phones, we have social media, and we can sit and scroll mindlessly for hours. So cut out 30 minutes of that mindless scrolling, get outside and take a walk. There's plenty of platforms that are free on YouTube or other social media platforms that you can get in movement, you don't have to pay for a membership, you can do body weight exercises, you don't even have to buy equipment. So I think a lot of people can easily grasp excuses, but there's really no reason we can't get some intentional movement in every day.

Host: Wonderful. Well, to wrap up, you mentioned that women wait longer than their male counterparts to receive care in an emergency setting when presenting with a suspected heart attack. So how can female patients in that setting best advocate for themselves?

Jessica Slavin, NP: Yeah, I think, like I said, don't think that you're wasting anyone's time, you know, women have a little bit of that mindset of, oh, I'm just, it's just something else on my plate I need to take care of, I don't want to take up someone's time and space, I've got so many things on my schedule that I need to get taken care of, but, we truly can't take care of our families and others if we don't take care of ourselves first.

So, if you have any concerns, any concerns whatsoever about your health, I would definitely press that you follow a primary care provider or get in to see a cardiologist if you haven't had any screening work done. I know that our health system offers certain times of the year a free EKG screening, so other health systems I know do that, especially, in the heart month in February. So take advantage of those, and don't question, your concerns, don't put them off.

Host: Jessica, thank you so much for joining us today and for all the work that you do for women and their heart health. And that wraps up this episode of Memorial Health Radio with Memorial Health System, Ohio. Head on over to our website at MHsystem.org for more information and to get connected with one of our providers. And please remember to subscribe, rate and review this podcast and all of the other Memorial Health System podcasts.