Transcript
Matthew DeVane, DO FACC: Hi, I'm Doctor Matt Devane.
Carolyn Lacey, MD FACC: And I'm Doctor Carolyn Lacey. We are cardiologists at John Muir Health and this is our podcast, Living Heart Smart.
Matthew DeVane, DO FACC: Our physician partners and colleagues are going to help guide you through many different and important cardiovascular topics to help keep your heart happy and healthy.
Carolyn Lacey, MD FACC: Thank you for listening and we hope you enjoy our show.
Matthew DeVane, DO FACC: Hey, everybody. February is American Heart Month, and this is Carolyn and I's favorite month of the year because everybody's talking about hearts these days, right? And anytime we can get people talking about heart prevention, heart disease, it's all the better. So there are a couple of things that kind of tipped me off that I think we should be doing a episode dedicated to women and heart disease. There were two kind of inspirations for this living Heart smart top five. Number one is that the first day, the first Friday of February, is National Wear Red day. What's that about?
Carolyn Lacey, MD FACC: It's an American Heart Association sponsored program where it's meant to bring awareness to women's heart disease by wearing red on the first Friday of every February.
Matthew DeVane, DO FACC: I like that spreading awareness is key, and that's what we're trying to do. The second inspiration for us doing this talk was my partner, doctor Lacy. You just did a luncheon awareness for a group here locally. Tell me about that.
Carolyn Lacey, MD FACC: I was asked to give a talk at our local chamber of commerce for a women's networking luncheon. We had a great turnout. We talked all about women's heart health, and I feel like we got some good information out there.
Matthew DeVane, DO FACC: Oh that's great, that's great. Well, any way we can get the word out, we're going to try it. So there are a ton of statistics out there and facts. But I think for women, for me, there are a few stand out that we've got a lot of work to do still. Number one is 1 in 5 deaths in this country are for women, are caused by cardiovascular disease. And sadly, most of those deaths are still mostly preventable. Right. So that's not good. The second is there are over 400,000 women having heart attacks every year in this country. And even more concerning than that is over 30,000 of those women are under the age of 55. And a lot of those people aren't even thinking about our disease.
Carolyn Lacey, MD FACC: A lot of those people are feeling like they're too young to even start thinking about it, right?
Matthew DeVane, DO FACC: And with that, that's what led us to bring you today our top five, which is women and heart disease. Top five takeaways. So let's dive right in. First of all, for all you women number one recognize your symptoms.
Carolyn Lacey, MD FACC: You. We're just going to say this to get it out of the way. But if you think you're having a heart attack, don't wait. Just call 911.
Matthew DeVane, DO FACC: Yeah. If you're not sure, you always err on the side of.
Carolyn Lacey, MD FACC: Err on the side.
Matthew DeVane, DO FACC: Just get help now. But the problem is women sometimes feel those symptoms a little bit differently, right?
Carolyn Lacey, MD FACC: Right. They do. And you know, our classic picture is going to be someone sitting with studying, someone sitting there. They have an elephant sitting on their chest radiating down their left arm. And and women sometimes do have that happen to them. And a lot of women will have some sort of chest discomfort, but they'll describe it as squeezing, pressure tightening, but they'll also have pain in their arm, pain to their back. When I start hearing pain radiating up to the neck and their jaw, then I'm starting to get a little suspicious. There will be a lot more abdominal discomfort, some nausea, shortness of breath. Yeah, lightheadedness. And this some women really describe this sort of tiredness or fatigue in their chest.
Matthew DeVane, DO FACC: Yeah I hear some of the women that I've seen having heart attacks is a little bit of discomfort in the chest. Pain isn't always the right word, but it's just also associated with this fatigue and this, like overwhelming sense that you don't want to move. Right? Right.
Carolyn Lacey, MD FACC: And sometimes it doesn't last for very long and it seems to get a little bit better. And because it could be confusing, maybe it's just my stomach, maybe it's something else. I've had patients that I see in the emergency department. For instance, I had one patient who. Was feeling better from a chest discomfort standpoint. Had this episode of Severe Chest Pain passed out at home, but then it got a little bit better. Okay. And still came into the emergency room because she just had this sense that there's something wasn't right. And ultimately she was right. Something wasn't right.
Matthew DeVane, DO FACC: Don't ignore that.
Carolyn Lacey, MD FACC: Don't ignore that feeling.
Matthew DeVane, DO FACC: Nobody really wants to go sit in the E.R. or have a lot of patients tell me they have this fear of being there but not having our problem, like maybe the gas or whatever don't. Doesn't matter. We do this every single day. We do this every day. That's what they are there for. So symptoms that you're not sure about. Call 911.
Carolyn Lacey, MD FACC: Call 911.
Matthew DeVane, DO FACC: Good. Number two women are built differently. I'm not sure how I can totally explain that, but I hope you have some more details about. Some say women are built better, but we'll just say for now, women are built differently.
Carolyn Lacey, MD FACC: So I think of this as a couple of really different big principles. Right. So women have different hormones than men, especially estrogen. We talk about estrogen all the time and it provides a lot of vascular protection in women. It stabilizes our blood pressure. It regulates our cholesterol and triglycerides. It also reduces inflammation. And women lose estrogen throughout the course of their lives, which is around the age of 50 for a lot of women. And that is part of the reason that's a large part of the reason why they have symptoms starting about ten years later than men do.
Matthew DeVane, DO FACC: The onset of at least atherosclerotic heart disease is thought to be delayed by about ten years compared to men, and that must be mostly related to estrogen.
Carolyn Lacey, MD FACC: Women also have smaller hearts and smaller vessels compared to men, and we see in women they have more microvascular disorders. So when we talk about the big arteries, but there are also they break down into these tiny little arteries, which are affected more in women than they are in men.
Matthew DeVane, DO FACC: Yeah, we do see that. And also this seems like some of the women are more prone to have this thing called vasospasm with those tiny little arteries get into spasm, whereas men don't see that as much. So that's a little another difference women have right there.
Carolyn Lacey, MD FACC: There are a couple of particular disorders that we see more in women, more of the autoimmune or inflammatory disorders such as rheumatoid arthritis and lupus. And we're finding that those inflammatory disorders really increase a woman's risk, a woman's risk. And finally, even though we're not necessarily thinking about it, pregnancy complications like preeclampsia, pregnancy induced hypertension, gestational diabetes that increases a woman's risk for developing heart disease for decades. And it's not something you're thinking about at that time of your life, right?
Matthew DeVane, DO FACC: Carolyn? I think the other thing you mentioned that was very important was this whole additional set of risk factors that some women face with these inflammatory disorders, right? Because what we're finding out is atherosclerosis and heart attacks are more than just cholesterol. It's cholesterol and inflammation and all sort of tied together. So it's just super important for people to recognize that. Good. Agreed. Thank you for bringing that up. The next thing is so many patients ask both of us, really, what are things we can do to protect our hearts without medications every day?
Carolyn Lacey, MD FACC: Yeah, I.
Matthew DeVane, DO FACC: Don't want pills. I don't want pills. Pills. Now, men or more. Just as likely to say this as women, but we're going to focus on things women can do to kind of get their hearts in shape without taking meds.
Carolyn Lacey, MD FACC: One thing I hear a lot from women is that they tend to be the caregivers. There's so much stress that's associated with caregiving, for sure.
Matthew DeVane, DO FACC: Oh my God, for sure.
Carolyn Lacey, MD FACC: Because you're caring for your your own family, for your parents, for spouses. You always feel women, always feel like they need to take all of this care on, and they sometimes neglect themselves or oftentimes neglect themselves.
Matthew DeVane, DO FACC: I see that so much because they're getting their other, you know, mother in law or whatever to the doctor, and they're running around and doing everything at home. So. Women. You got to take care of yourselves, right? So what are some things women can do to help? Kind of get some of that in check without taking pills.
Carolyn Lacey, MD FACC: So stress management, good adaptive ways to manage your stress. Really important. There are so many options out there, so many things that you just have to try a couple stress management techniques out and see if that helps. I think that quality sleep is really important, and the more that time goes on, the more we're realizing sleep, sleep, sleep, having good sleep, not neglecting your sleep is really important. We need to make good food choices. Eating whole foods, whole grains, healthy fats are really important. Moving more. We all need to move more.
Matthew DeVane, DO FACC: Exactly. Yeah, 30 minutes a day or more would be great, but we'll take what we can get.
Carolyn Lacey, MD FACC: We'll take what we can get. And little, little, little amounts count to um. And we need to say it because we need don't smoke.
Matthew DeVane, DO FACC: If you smoke, smoke quit. Uh, the good point. What about are we are getting patients asking us more about marijuana use. What's the update there?
Carolyn Lacey, MD FACC: So marijuana is not necessarily as safe as everyone thought it was going to be. And there's some data coming out that suggests that marijuana really is cardiotoxic.
Matthew DeVane, DO FACC: That's what we're seeing for sure. So I would just remind women, if you want to keep taking care of the rest of your family, take care of yourself, make it a priority. Good. And so along those lines also, let's go beyond that. Women also have to look at their own cardiovascular risk. And what's a good way for women to do that?
Carolyn Lacey, MD FACC: Go see your doctor.
Matthew DeVane, DO FACC: There you go. That's a good starting point. I and we talked about this a little bit, but I'm trying to make this for a lot of you only go to see your doctor once a year because you otherwise healthy. Right. So let's make February National Heart Month. Let's do it that month that you're going to go.
Carolyn Lacey, MD FACC: That's when you're going to go see your doctor, because your doctor is really going to help you understand your heart health numbers. And if you can, you know, we've talked about risk factors before, and we've talked about our heart health numbers. In fact, if you go to our top five resolutions episode, we'll talk about blood pressure and LDL glucose and our weight. Knowing these numbers really help protect us from developing risk factors and our risk factors. Even the standard risk factors hypertension, diabetes, high cholesterol, they still count in women as well. And if you develop with those risk factors, you need to work with your doctors to get them under control.
Matthew DeVane, DO FACC: Yeah. Agreed. So pick February, go get your see your doctor and get all your numbers done. Perfect. Now this brings us to our fifth point, and I think this ones we've discussed a lot where we should go with number five. But we were talking about it and we kind of thought about looking out into our waiting room and what kind of population of women we see out there. And it's a mixed crowd even, you know, we do see a fair amount of people that are in their 70s and 80s, as well as some younger women. So I think number five for us is just saying it's never too late to start.
Carolyn Lacey, MD FACC: It's never too late to start. That being said, it's also never too early to start. Yeah, right. Heart disease starts in our 20s. It's unrelenting in the human body. It will develop throughout the course of our life, and anything you can do to really start impacting that course will improve your health span. And it doesn't matter when it's when you start, just start.
Matthew DeVane, DO FACC: It doesn't. I think people are always looking for some sort of trigger to say, well, I'm going to start next week or it's too late because I didn't make the changes. I've already gained this weight or my numbers are too high.
Carolyn Lacey, MD FACC: I already had a heart attack.
Matthew DeVane, DO FACC: Yeah, no, the benefits of starting today are real and long lasting. And just for me personally, every Monday I wake up and I think, how can I recommit to being smart again about what I'm doing? So it's never too late. It's never too late. I like what you said. Also, it's never too early.
Carolyn Lacey, MD FACC: It's never too.
Matthew DeVane, DO FACC: Early. We we need to start thinking about our disease earlier. Perfect. Well, that is fantastic. So those are our top five takeaways for women and heart disease. We hope you all learn something out of this and we look forward to seeing you in the office.
Carolyn Lacey, MD FACC: Take care. Thanks a lot.
Matthew DeVane, DO FACC: This is Doctor Matt Devane and on behalf of my co-host, Doctor Carolyn Lacey and our partners at John Muir Health, we hope that you enjoyed this show and we really hope that you keep living heart smart.
back to top