The Health series is presented by AdventHealth
A Conversation with Michelle Dew, MD, FACC, Cardiologist with AdventHealth Medical Group and Medical Director of Women’s Heart Care at AdventHealth
The eyes may be the window to the soul, but the mouth—surprisingly—can be a portal to a woman’s heart. Oral health is just one of many hidden factors that contribute to women’s heart health.
Although 51 percent of the U.S. population is female, for years, women’s heart health was misunderstood, misdiagnosed, or just plain missed as doctors relied on research done on men. But all that is changing.
Michelle Dew, MD, FACC, cardiologist with AdventHealth Medical Group and medical director of Women’s Heart Care at AdventHealth, explains more.
Why does heart health in women seem to be less straightforward than that for men?
Heart health can be complicated. Between the coronary arteries, heart rhythms, valves, and the electrical system, there are many parts that keep the heart working. For so many years, the medical establishment has been focused on male patients when identifying symptom patterns, performing research, and developing treatments. Our medical teachings and textbooks did not previously address female differences, one of the reasons of which was to avoid monthly hormonal variations as well as pregnancy. More recently, research has shown that women’s hearts are different from men’s. Hormonal influence, size, physiology, and propensity for certain diseases affects women’s heart health differently than men.
Today, there is more interest and research to specifically address our gender health differences. Unfortunately, if your provider isn’t up-to-date or doesn’t have a particular interest in women’s cardiac health, you may be compared to the old teachings which were primarily based on male patients. Heart disease is the number one killer of women, sometimes because of a delayed or missed diagnosis. Speaking with an up-to-date provider may make a big difference in your heart health.
What might be a few underlying health factors that could impact heart issues in women?
There are many specific conditions that have a higher association with heart diseases. Lupus, rheumatoid arthritis, sarcoidosis, certain cancers such as carcinoid and breast cancer, even endometriosis and PCOS are associated with higher risk for cardiovascular disease (CVD). Some treatments for these conditions can also have cardiac complications. Diabetic women have a greater risk of CVD than diabetic men.
Oral health is also related to heart health. Dental cavities and gum disease cause chronic, low-level inflammation which has been associated with increased risk for stroke and heart disease. Regular brushing, flossing, and dental check-ups can really make a difference.
Our female hormones can also impact our heart health. Throughout a woman’s life, estrogen, progesterone, and testosterone are more impactful on the cardiovascular system than you may think. Monthly cycles can contribute to palpitations; pregnancy could bring on preeclampsia, gestational hypertension, or diabetes. Changes associated with menopause may cause increased cholesterol and hypertension.
What are warning signs of heart problems in women?
I always tell my patients that “change” is what we are most interested in. If you find yourself short of breath or just worn out after routine tasks, then your medical provider needs to know. A primary care provider can order a stress test, ultrasound of your heart, and make a referral to a cardiologist if needed. A quick, dedicated calcium score/CT scan of your heart can provide additional information regarding your personal risks for cardiovascular disease. Unexplained dizziness, chest/back/shoulder discomfort, or unreasonable fatigue could also be warning signs that something is wrong with your heart.
Regular exercise is important on so many levels. Each time you work out, take a long walk or increase your heart rate for 20 minutes or more is a “stress test” for the heart. This is not only helpful for both your brain and body but as a marker for “change.”
Remember: if something feels different to you, talk to your provider. Try to collect data before your appointment, such as blood-pressure readings, weight fluctuations, symptoms, and the days and conditions under which they occurred. Knowing your numbers is just part of living a healthy life, making the most of your body.