Current researches have indicated that the most common health-related problems in women do not only include cervical cancer and breast cancer, but cardiovascular disease. A number of women diagnosed with cardiovascular disease has continued to rise worldwide. According to World Health Organization (WHO), cardiovascular disease is the leading cause of death for both men and women globally. An estimated 17.9 million people died from cardiovascular disease in 2016, representing 31% of all global deaths. In Thailand, The Ministry of Public Health reveals that in the last decade, approximately 4 Thais have died from cardiovascular disease in each hour. This mortality rates seem to increase continuously, especially in women.

More interestingly, nearly 63% of women who had never experienced any sign or symptom of cardiovascular disease have died due to sudden cardiac death. The risk of developing cardiovascular disease is greater in working women aged over 35 or postmenopause women with less estrogen level. A decline in the natural hormone estrogen is a potential factor in heart disease among post-menopausal women. Clinical studies indicate that estrogen illustrates a positive effect on the inner layer of artery wall, helping blood vessels to be flexible, thus they can relax and expand to accommodate sufficient blood flow. When estrogen level decreases, blood vessels become less flexible, causing cardiovascular disease as a consequence.

Silent dangers: coronary artery disease

Coronary artery disease is the narrowing or blockage of the coronary arteries, usually caused by atherosclerosis. Atherosclerosis or hardening of the arteries is the buildup of cholesterol and fatty deposits (known as atherosclerotic plaques) on the inner walls of the arteries. If coronary arteries narrow, they cannot supply sufficient oxygen-rich blood to the heart. Symptoms are induced especially when the heart is beating hard such as during exercise. In the beginning phase, the decreased blood flow to the heart may not cause any noticeable symptoms. As plaque continues to build up in the affected coronary arteries, patients might develop signs and symptoms, including chest pain (angina) described as pressure or tightness in the chest, as if someone were standing on the chest, fleeting or sharp pain in the neck, arm or back, shortness of breath or extreme fatigue during exertion. If left untreated, it might lead to fatal conditions such as:

• Heart attack. If plaque ruptures and a blood clot forms, complete blockage of the artery may potentially induce a heart attack. The lack of blood flow to the heart may damage the heart muscle, causing the death of heart muscle, known as myocardial infarction.
• Heart failure. If some areas of the heart are chronically deprived of oxygen and nutrients due to limited blood flow, or if the heart has been damaged by a heart attack, the heart may become too weak to pump enough blood to meet the body’s demand, causing heart failure.

Women at greater risks of coronary artery disease 

Women with potential risk factors to develop coronary artery disease include:

• Working women aged over 35 with high stress levels;
• Highly responsive jobs e.g. management committee, journalist and event planners;
• Central obesity or abdominal obesity;
• Physical inactivity with less exercise;
• Working at the table 7-8 hours per day;
• High-pressure jobs e.g. sales representatives; and
• Lack of health concerns
   

Contributing factors of women to develop coronary artery disease

In addition, other factors can play a significant role in the development of heart disease in women. These risk factors include:

• Unhealthy lifestyles e.g. lack of sufficient sleep and eating unhealthy foods.
• Emotional disturbance: Stress and depression largely affect women’s hearts more than men’s. Depression results in high degree of difficulties to maintain a healthy lifestyle.
• Physical inactivity. A lack of physical activity is one of major risk factors for heart disease. Some researches have found women to be less active than men.
• Hormonal changes: Low levels of estrogen after menopause pose a significant risk of developing heart disease.
• Complications during pregnancy: Hypertension or diabetes during pregnancy can increase the mother’s long-term risk of high blood pressure and diabetes. Therefore, the conditions also make women more likely to get heart disease.
• Family history of early heart disease: This factor appears to be a greater risk factor particularly in women than in men.

Warning signs and symptoms of cardiovascular disease

Manifestations that typically indicate cardiovascular disease include:

• Chest pain or angina described as pressure or tightness in the chest, as if someone were standing on the chest or the chest is pressed with the stone. Chest pain is often induced by physical activity or emotional stress e.g. being panic, anxious or nervous. The pain usually goes away within 2-3 minutes after stopping the stressful activity. Especially women, this pain might radiate to the neck, jaw, arms, shoulders or back.
• Being tired easily especially after exertion or exercise. It suddenly happens within 1-2 weeks.
• Fleeting or sharp pain in the chest especially when breathing in deeply, coughing, sneezing or moving positions.
• Extreme shortness of breath or difficulty breathing (dyspnea) that worsens with activity or when lying down.
• Fainting or severe weakness due to a sudden drop of blood pressure accompanied with chest pain.
• High blood pressure and blood cholesterol, greater than 200 mg/dL.

 
Lifestyle changes to lower risks of cardiovascular disease

Lifestyle modifications can largely help to minimize the risks of cardiovascular disease. To keep the heart healthy, it is highly recommended to:

• Have regular health check-ups with screening of complete blood count (CBC), blood pressure level, blood sugar level and blood lipid level;
• Have annual heart check-ups with expert cardiac specialists;
• Manage stress. Stress should be reduced as much as possible. Practice healthy techniques for managing stress might include meditation, travelling and spending time with friends and family.
• Exercise regularly. Exercise helps to control diabetes, elevated cholesterol and high blood pressure as well as maintain a healthy weight.
• Maintain a healthy weight. Being obese or overweight increases risk of coronary artery disease and other health-related problems.
• Stop smoking. Smoking is a major risk factor for heart disease. Several substances in cigarette affect the heart’s health. For instance, nicotine constricts blood vessels and forces the heart to work harder while carbon monoxide reduces oxygen in the blood and damages the lining of the blood vessels.
• Eat healthy foods. A heart-healthy diet such as plant-based foods e.g. fruits and vegetables, food with low saturated fat, cholesterol and sodium e.g. whole grains, legumes and nuts can help controlling weight, blood pressure and cholesterol. Eating one or two servings of fish a week also is beneficial. Avoid saturated fat and trans fat, excess salt and excess sugar. Alcohol consumption should be limited, or avoided if possible.

Heart check-ups with Bangkok Heart Hospital

Bangkok Heart Hospital. Over years of our expertise in comprehensive heart care, we have ultimately aimed to treat all cardiovascular diseases by highly experienced and well-trained cardiac specialists in all subspecialties. Supported by cutting-edge and advanced technology in cardiology practice, patients can rest assured that they always receive accurate and timely diagnosis, effective and appropriate treatments as well as holistic rehabilitation care for the best possible outcomes.

Our heart screening programs include:

• Chest-X ray: A chest x-ray produces images of the heart, lungs, airways, blood vessels and the bones of the spine and chest.
• Electrocardiogram: ECG or EKG is a test that checks heart’s function by measuring the electrical activity of the heart.
• Cardiac enzyme test: A blood test that measures the cardiac enzymes in the blood to determine the damages to the heart muscles.
• Exercise stress test: A cardiac stress test is a test that measures the heart’s ability to respond to external stress in a controlled clinical environment. The stress response is induced by either exercise or intravenous pharmacological stimulation.
• Echocardiogram: An echocardiogram is a graphic outline of the heart’s movement to visualize heart valve, chamber and structure as well as evaluate the pumping action of the heart.
• Computed Tomographic Angiography: Computed tomography angiography is a computed tomography technique used to visualize arterial and venous vessels throughout the body.
• Cardiac Catheterization: Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. This is done both for diagnostic and interventional purposes.
• Coronary Angiogram: Coronary angiogram is a special X-ray test to identify the blockage of coronary arteries.

Bangkok Heart Hospital is dedicated to provide a wide range of services with international standard. The ultimate goal is to achieve the excellent care in all cardiac conditions. Bangkok Heart Hospital is comprehensively specialized in cardiovascular diseases covering all specialties and subspecialties. Off-Pump CABG can be safely performed with our highly experienced and well-trained cardiothoracic surgeons. In addition, all cardiac interventions are round-the-clock ready. Our skilled and expert cardiac specialists are available 24/7 to provide prompt and effective treatments. In addition, we are well-equipped with the most advanced technology and equipment in cardiac and vascular practice. Our cutting-edge technology include Hybrid OR, ECMO with medical transportation covering all routes. More importantly, our BDMS network consists of multidisciplinary teams in more than 48 hospitals. This networking structure efficiently enables us to collaborate and support each other in order to a get our vision accomplished.