Women often tend to ignore many of the symptoms of heart disease. It is important that women know the risks factors and signs of heart disease as it applies to women. The symptoms in men may be quite different than the symptoms in women.
Listen as Dr. Mallory Balmer-Swain discusses heart disease and why women especially need to be vigilant and aware of the risks and symptoms of heart disease.
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Heart Disease in Women
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Learn more about Mallory Balmer-Swain, DO
Mallory Balmer-Swain, DO
Dr. Mallory Balmer-Swain, DO, FACC has been a non-invasive cardiologist at the Sands-Constellation Heart Institute since 2015. She earned her bachelor of science degree at The Pennsylvania State University and her doctorate at Philadelphia College of Osteopathic Medicine.Learn more about Mallory Balmer-Swain, DO
Transcription:
Heart Disease in Women
Bill Klaproth (Host): According to the CDC, heart disease is the leading cause of death for women in the United States, about one in every four female deaths. However, women often ignore some of the symptoms of heart problems. Here to help us find out what those are and how you can keep your heart healthy is Dr. Mallory Balmer-Swain of Rochester Regional Health. Dr. Balmer, thanks for your time today. So how is women's heart disease different than men’s heart disease?
Dr. Mallory Balmer-Swain (Guest): The most important thing, I think, is that women develop heart disease a little bit later than men. Looking at family history, we look at folks who’ve had a maternal or mother -- female relatives who have had heart disease that develops 65 and older, whereas men tend to develop heart disease younger, 55 and older usually.
Bill: So later than men, and you look at family history, and then for somebody that’s in that range -- maybe older, and should be paying attention to it -- how do the symptoms of heart disease differ between men and women?
Dr. Balmer-Swain: Sure. In the media for example, if you're watching a movie or a television show and they depict a man having a heart attack, it’s the classic symptoms of crushing chest pain, central chest pain, sometimes radiating down the left arm and that does happen in women sometimes, but a lot of times it’s more subtle. It may just be a pressure or a tightness in the chest. I’ve even seen women who have jaw pain, or even just shoulder pain, or back pain representing a heart condition. I think the most important thing that I look for is a pattern of symptoms that come on when they exert themselves and get better with rest. And that may be, again, just jaw discomfort, shoulder discomfort, nausea even. It can present just like a man, but it can present in a multitude of other ways.
Bill: So if someone feels any of those symptoms, what should they do next? Should they just call their doctor or is this -- Emergency Room? What should they do?
Dr. Balmer-Swain: Good question. Usually, if there’s a new symptom that is concerning -- such as pressure, tightness in the chest, something that is new for that patient and doesn’t go away quickly, meaning in less than two minutes -- the best thing is just to get to the Emergency Room and be checked out to be sure. We often see patients in the office who are having briefer episodes, things that go away with rest and I think it’s reasonable -- for example, if you have an episode of chest discomfort that goes away quickly -- it’s reasonable to call your doctor first and get checked out, but anything that comes and doesn’t go away pretty quickly, you should really get in to be seen in the Emergency Department sooner than later.
Bill: I just want to be clear on that for anyone listening. Pressure, or tightness in the chest, you mentioned also jaw, shoulder, or back pain. Those are, would you say, the classic symptoms for a female that’s experiencing heart issues?
Dr. Balmer-Swain: Yes, they’re more common in women to have things like shoulder and jaw pain, rather than the classic pain in the center of the chest. I should also point out that it’s not just pain, I also worry about things like pressure, tightness, heaviness sometimes is described. Pain, a lot of folks come in and they say, “Well, I didn’t really have pain, and so I didn’t think that it was a problem.” Heaviness, tightness, pressure are also concerning symptoms.
Bill: And that usually presents with exertion, correct?
Dr. Balmer-Swain: Correct.
Bill: Okay, so if you’re sitting, watching TV and you feel a tightness in your chest, that still could be a symptom, or problematic?
Dr. Balmer-Swain: It could be, but less commonly. It’s still something I would say that should be checked out by your doctor, but the really concerning ones are the ones that come on when you’re exerting yourself.
Bill: And you mentioned family history earlier, can you talk about that hereditary aspect a little bit more?
Dr. Balmer-Swain: Sure. So again, we look at – on the female relatives, we look for any sign of heart disease, meaning heart attacks, folks having stents or bypass surgery before the age of 65 in women or before the age of 55 in men. We also look at diabetes runs in families, so that’s one risk factor, high blood pressure, cholesterol. All of those things can be carried in families and increase the person’s risk for heart disease.
Bill: And what about other risk factors? Can you talk about lifestyle behaviors as well that contribute to heart disease in women?
Dr. Balmer-Swain: Sure, and I think that’s one of the most important things. Smoking is probably number one in my mind of risk factors that can be modified. If you smoke, quitting smoking is one of the best things you can do to prevent yourself from having heart disease and that actually includes both heart attack and stroke. Diet and exercise are extremely important. More than looking at numbers you want to make sure you're exercising at least 30 minutes a day, five days a week. And then diet, you want to have lots of vegetables, high fiber, and less carbohydrates, avoid fried foods. Those things are actually just as important as any medications that I can give to prevent heart disease.
Bill: So those are really good tips, quit smoking, pay attention to diet and exercise, 30 minutes a day, five days a week, and then pat attention to vegetables and high fiber. If you’re looking for a quick way to introduce more vegetables into your diet, what would you recommend? Should somebody just make a simple swap of trying to get one more vegetable or two more vegetables in per day?
Dr. Balmer-Swain: I think that’s a good way to do it. Personally, I try to make sure I have at least one serving of vegetable with lunch and dinner. One easy way to do it is – because we only do things that are easy for ourselves. You’re not going to prepare a salad for every meal, that’s a lot of work. If you can prepare things ahead of time, so for example, portion out some carrots, or peppers, or whatever you like to munch on. That way when you’re making your lunch in the morning, or throughout the day if you need a snack, you can just grab something quickly and it doesn’t require prep time. So, I think just making things easier for yourself and preparing ahead of time is one of the best things you can do.
Bill: And Dr. Balmer, if someone is diagnosed with heart disease, what are the treatment options and can it be reversed with lifestyle changes?
Dr. Balmer-Swain: Sure, good question. There’s actually – there were some studies done – Steve Nissen – he’s done some research looking at the ability of the body to reverse heart disease with diet. I’ll tell you that he did have some success, but it was an extremely strict, vegetable-only diet, which is almost impossible for most people. Having said that, though, I think that diet and exercise are still important. And we use medications to supplement that. A lot of people have a heard of statin medications, which are cholesterol pills. The newer guidelines, actually we don’t target cholesterol numbers, we put folks on statin pills when they’re at high risk of having heart disease, or if they already have heart disease because it actually reduces the risk of further heart attacks, needing more stents, strokes, and so forth, so that’s usually part of the treatment. We also use blood pressure pills, which help reduce the blood pressure, but also reduce the risk of further heart attack. And an Aspirin is almost always incorporated in folks who have coronary artery disease.
Bill: Alright, well those are very good tips. And are there any female-specific disorders that increase a women’s risk of heart disease?
Dr. Balmer-Swain: Well, it’s an interesting question. As far as our usual coronary artery disease due to blockages and plaques, there aren’t really any female-specific – and interestingly, estrogen is probably protective, which is why to see heart disease later in women. But I will tell you, there are other types of heart disease that do happen in women much more. One of them is called spontaneous coronary artery dissection in which, usually young women, have a dissection, or a splitting of the artery of the heart, which can cause heart attacks. And then there’s also stress-related heart problems, like a stress cardiomyopathy where they can actually have heart failure related to stress and women are much more susceptible to that. Those are definitely – and they can present in young women, as well, which is one of the things that I think causes the women to delay seeking care.
Bill: I guess the main point is, in listening to you, is really you have to pay attention to your heart. You really have to practice proper lifestyle behaviors and make sure you're paying attention to symptoms and get your diet, exercise, etcetera because this is a leading cause of death in women. Pay attention to your heart.
Dr. Balmer-Swain: Exactly, and pay attention to your whole body, too because one thing that I see time and again, is that women delay seeking treatment because they’re busy, they're taking care of the kids, or the husband, or the parents, or whoever. They’re taking care of everybody but themselves and so if I could give one piece of advice to women it's paying attention to yourself and take care of yourself.
Bill: I think that is a great point. Dr. Balmer, if you could wrap it up for us, why should someone choose Rochester Regional for their heart health needs?
Dr. Balmer-Swain: Sure. I think Rochester Regional is a great place to go for any heart needs and the reason why I actually work here is the same reason, which is that we’ve got a great team of people and we’ve got a lot of new treatments, state-of-the-art facilities, and treatments that we can use. Not only that, I’ve got a great team. For example, today I had a patient with a rhythm problem, and I’ve got a rhythm specialist right in my office, so I can talk to him, and then I’ve got a structural heart disease specialist in the next office. We all work together great as a team, so that’s why I’m here and that’s why I think it’s a good place.
Bill: Well that’s all very important to know, and thank you again, Dr. Balmer, for your time.
Dr. Balmer-Swain: Sure.
Bill: You’re listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to RochesterRegional.org, that’s RochesterRegional.org. I’m Bill Klaproth, thanks for listening.
Heart Disease in Women
Bill Klaproth (Host): According to the CDC, heart disease is the leading cause of death for women in the United States, about one in every four female deaths. However, women often ignore some of the symptoms of heart problems. Here to help us find out what those are and how you can keep your heart healthy is Dr. Mallory Balmer-Swain of Rochester Regional Health. Dr. Balmer, thanks for your time today. So how is women's heart disease different than men’s heart disease?
Dr. Mallory Balmer-Swain (Guest): The most important thing, I think, is that women develop heart disease a little bit later than men. Looking at family history, we look at folks who’ve had a maternal or mother -- female relatives who have had heart disease that develops 65 and older, whereas men tend to develop heart disease younger, 55 and older usually.
Bill: So later than men, and you look at family history, and then for somebody that’s in that range -- maybe older, and should be paying attention to it -- how do the symptoms of heart disease differ between men and women?
Dr. Balmer-Swain: Sure. In the media for example, if you're watching a movie or a television show and they depict a man having a heart attack, it’s the classic symptoms of crushing chest pain, central chest pain, sometimes radiating down the left arm and that does happen in women sometimes, but a lot of times it’s more subtle. It may just be a pressure or a tightness in the chest. I’ve even seen women who have jaw pain, or even just shoulder pain, or back pain representing a heart condition. I think the most important thing that I look for is a pattern of symptoms that come on when they exert themselves and get better with rest. And that may be, again, just jaw discomfort, shoulder discomfort, nausea even. It can present just like a man, but it can present in a multitude of other ways.
Bill: So if someone feels any of those symptoms, what should they do next? Should they just call their doctor or is this -- Emergency Room? What should they do?
Dr. Balmer-Swain: Good question. Usually, if there’s a new symptom that is concerning -- such as pressure, tightness in the chest, something that is new for that patient and doesn’t go away quickly, meaning in less than two minutes -- the best thing is just to get to the Emergency Room and be checked out to be sure. We often see patients in the office who are having briefer episodes, things that go away with rest and I think it’s reasonable -- for example, if you have an episode of chest discomfort that goes away quickly -- it’s reasonable to call your doctor first and get checked out, but anything that comes and doesn’t go away pretty quickly, you should really get in to be seen in the Emergency Department sooner than later.
Bill: I just want to be clear on that for anyone listening. Pressure, or tightness in the chest, you mentioned also jaw, shoulder, or back pain. Those are, would you say, the classic symptoms for a female that’s experiencing heart issues?
Dr. Balmer-Swain: Yes, they’re more common in women to have things like shoulder and jaw pain, rather than the classic pain in the center of the chest. I should also point out that it’s not just pain, I also worry about things like pressure, tightness, heaviness sometimes is described. Pain, a lot of folks come in and they say, “Well, I didn’t really have pain, and so I didn’t think that it was a problem.” Heaviness, tightness, pressure are also concerning symptoms.
Bill: And that usually presents with exertion, correct?
Dr. Balmer-Swain: Correct.
Bill: Okay, so if you’re sitting, watching TV and you feel a tightness in your chest, that still could be a symptom, or problematic?
Dr. Balmer-Swain: It could be, but less commonly. It’s still something I would say that should be checked out by your doctor, but the really concerning ones are the ones that come on when you’re exerting yourself.
Bill: And you mentioned family history earlier, can you talk about that hereditary aspect a little bit more?
Dr. Balmer-Swain: Sure. So again, we look at – on the female relatives, we look for any sign of heart disease, meaning heart attacks, folks having stents or bypass surgery before the age of 65 in women or before the age of 55 in men. We also look at diabetes runs in families, so that’s one risk factor, high blood pressure, cholesterol. All of those things can be carried in families and increase the person’s risk for heart disease.
Bill: And what about other risk factors? Can you talk about lifestyle behaviors as well that contribute to heart disease in women?
Dr. Balmer-Swain: Sure, and I think that’s one of the most important things. Smoking is probably number one in my mind of risk factors that can be modified. If you smoke, quitting smoking is one of the best things you can do to prevent yourself from having heart disease and that actually includes both heart attack and stroke. Diet and exercise are extremely important. More than looking at numbers you want to make sure you're exercising at least 30 minutes a day, five days a week. And then diet, you want to have lots of vegetables, high fiber, and less carbohydrates, avoid fried foods. Those things are actually just as important as any medications that I can give to prevent heart disease.
Bill: So those are really good tips, quit smoking, pay attention to diet and exercise, 30 minutes a day, five days a week, and then pat attention to vegetables and high fiber. If you’re looking for a quick way to introduce more vegetables into your diet, what would you recommend? Should somebody just make a simple swap of trying to get one more vegetable or two more vegetables in per day?
Dr. Balmer-Swain: I think that’s a good way to do it. Personally, I try to make sure I have at least one serving of vegetable with lunch and dinner. One easy way to do it is – because we only do things that are easy for ourselves. You’re not going to prepare a salad for every meal, that’s a lot of work. If you can prepare things ahead of time, so for example, portion out some carrots, or peppers, or whatever you like to munch on. That way when you’re making your lunch in the morning, or throughout the day if you need a snack, you can just grab something quickly and it doesn’t require prep time. So, I think just making things easier for yourself and preparing ahead of time is one of the best things you can do.
Bill: And Dr. Balmer, if someone is diagnosed with heart disease, what are the treatment options and can it be reversed with lifestyle changes?
Dr. Balmer-Swain: Sure, good question. There’s actually – there were some studies done – Steve Nissen – he’s done some research looking at the ability of the body to reverse heart disease with diet. I’ll tell you that he did have some success, but it was an extremely strict, vegetable-only diet, which is almost impossible for most people. Having said that, though, I think that diet and exercise are still important. And we use medications to supplement that. A lot of people have a heard of statin medications, which are cholesterol pills. The newer guidelines, actually we don’t target cholesterol numbers, we put folks on statin pills when they’re at high risk of having heart disease, or if they already have heart disease because it actually reduces the risk of further heart attacks, needing more stents, strokes, and so forth, so that’s usually part of the treatment. We also use blood pressure pills, which help reduce the blood pressure, but also reduce the risk of further heart attack. And an Aspirin is almost always incorporated in folks who have coronary artery disease.
Bill: Alright, well those are very good tips. And are there any female-specific disorders that increase a women’s risk of heart disease?
Dr. Balmer-Swain: Well, it’s an interesting question. As far as our usual coronary artery disease due to blockages and plaques, there aren’t really any female-specific – and interestingly, estrogen is probably protective, which is why to see heart disease later in women. But I will tell you, there are other types of heart disease that do happen in women much more. One of them is called spontaneous coronary artery dissection in which, usually young women, have a dissection, or a splitting of the artery of the heart, which can cause heart attacks. And then there’s also stress-related heart problems, like a stress cardiomyopathy where they can actually have heart failure related to stress and women are much more susceptible to that. Those are definitely – and they can present in young women, as well, which is one of the things that I think causes the women to delay seeking care.
Bill: I guess the main point is, in listening to you, is really you have to pay attention to your heart. You really have to practice proper lifestyle behaviors and make sure you're paying attention to symptoms and get your diet, exercise, etcetera because this is a leading cause of death in women. Pay attention to your heart.
Dr. Balmer-Swain: Exactly, and pay attention to your whole body, too because one thing that I see time and again, is that women delay seeking treatment because they’re busy, they're taking care of the kids, or the husband, or the parents, or whoever. They’re taking care of everybody but themselves and so if I could give one piece of advice to women it's paying attention to yourself and take care of yourself.
Bill: I think that is a great point. Dr. Balmer, if you could wrap it up for us, why should someone choose Rochester Regional for their heart health needs?
Dr. Balmer-Swain: Sure. I think Rochester Regional is a great place to go for any heart needs and the reason why I actually work here is the same reason, which is that we’ve got a great team of people and we’ve got a lot of new treatments, state-of-the-art facilities, and treatments that we can use. Not only that, I’ve got a great team. For example, today I had a patient with a rhythm problem, and I’ve got a rhythm specialist right in my office, so I can talk to him, and then I’ve got a structural heart disease specialist in the next office. We all work together great as a team, so that’s why I’m here and that’s why I think it’s a good place.
Bill: Well that’s all very important to know, and thank you again, Dr. Balmer, for your time.
Dr. Balmer-Swain: Sure.
Bill: You’re listening to Rock Your Health Radio with Rochester Regional Health. For more information, you can go to RochesterRegional.org, that’s RochesterRegional.org. I’m Bill Klaproth, thanks for listening.