Putting the spotlight on women’s cardiac health

While cancer is a much-hyped topic, we often seem to overlook another common cause of deaths — cardiac problems. In fact, this is one of the leading causes of death in women worldwide. In order to elaborate on this matter, while spreading awareness and knowledge, the third International Conference on Cardiac Intervention was held on 26 January, 2020 at the Pan Pacific Sonargaon Dhaka.

The conference brought together doctors from national boundaries and overseas. It was a highbrow conference, with interesting debate sessions and thought-provoking discussions. To shed light on women's cardiac health Dr Abi Al-Hussaini, one of the brilliant minds in this field, and an attendant of the conference, shared her scholarly insights. She is a consultant cardiologist at Chelsea and Westminster Hospital, and Royal Brompton Hospital.

Women are most susceptible to three cardiovascular diseases, which are broken heart syndrome, also known as takotsubo, postpartum cardiomyopathy, and spontaneous coronary artery dissection. 

Among these, takotsubo mainly effects postmenopausal women, and women in their perimenopause. This seems like a heart attack and causes damage to the bottom of the heart, in the muscles. The cause for this is likely related to hormonal changes and stress. The bodily changes women go through, such as hormonal changes, monthly menstruation, peri and postmenopausal conditions all play a massive role in developing cardiovascular diseases. Although most cases can be treated within six weeks, early diagnosis is imperative.

Spontaneous coronary artery dissection also mimics a heart attack, and is mainly caused by stress. However, unlike takotsubo, this one shows a dissection or tear in the arteries of the heart inside an angiogram. This condition normally affects women from their '20s to '50s. This ailment is hard to diagnose and treat. Because a heart condition in younger women is uncommon, many doctors initially assume it is muscular pain or indigestion. Whenever women face chest pain that lasts longer than usual, they should seek medical attention.    

New mothers are vulnerable to postpartum cardiomyopathy, as the heart becomes dilated after delivering a baby. Within a few weeks, symptoms such as shortness of breath, fatigue, and palpitation, usually occur. Multiple pregnancies can potentially be a risk factor. Thus, if a mother has had this malady once, another pregnancy will be risky. While there is no optimum number of pregnancies, risks and complications usually start after the third pregnancy, especially in aging mothers. 

Although statistics suggest that only about 1-2 percent of all mothers are afflicted with this disease, the figures may be higher, given that many cases go undiagnosed. Furthermore, this condition is challenging to treat because the mother is usually busy with nurturing the new born and getting along with motherhood.

Treatment options include certain medications, but this will impact breastfeeding, mostly bringing it to a halt. Moreover, the most suitable treatment plan can vary from person to person. While some women may require a hormone replacement therapy, not getting pregnant in the future may be right for others.

When asked about preventive measures, Dr Al-Hussaini lay emphasis on the importance of early diagnosis and treatment in order to prevent further complications such as heart failure and heart rhythm abnormality. Other than that, women should routinely get their blood pressure, cholesterol profile, diabetic condition, BMI, and weight checked. Any noticeable variance must be brought under control through stringent measures.

Luckily, all these conditions can be somewhat prevented through lifestyle changes. Moderate exercise on a regular basis for 30-45 minutes is an option. This can be brisk walking, cycling, or doing house chores that make one sweat.

Having dinner early and eating a balanced and healthy diet with lots of vegetables, some protein, and meagre fat is advised. This is essential because as women age, their metabolic rate goes down, making it easy to put on weight. Wearing an air mask while outside will provide some protection as well, especially while roaming in the streets of Dhaka, given its poor air quality.  

Additionally, taking care of our mental wellbeing is as important as maintaining good physical wellbeing. Women pose a higher risk of depression and stress related disorders. Doing stress relieving activities along with everything else is necessary. Practicing a hobby, socialising, taking days off, finding time for oneself— all contribute to lowering the level of stress.

Lastly, when questioned about giving a final advice to women regarding their cardiac health, Doctor Al-Hussaini replied that getting diagnosed early is always the best treatment. One should make sure that they are aware of risk factors, and even if the symptoms start early, they should not be ignored."

Despite the fact that women are busy running errands and doing household chores, it is essential that any unexplained abnormality in the body be given prompt medical attention. Women in Bangladesh seem to believe they are bound to become weak and fragile at a certain age. This is normal during their '70s or '80s, but before that, if women have trouble continuing daily actions, it should be considered a cause for concern.