Tailoring Cardiac Care for Women
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This article appears in the December issue of HealthLeaders magazine.
Confusion and uncertainty cloud the issue of women's heart disease, and perhaps surprisingly that lack of clarity is even evident among physicians—or at least among those who aren't cardiologists.
Heart disease is the leading cause of death in females, but this fact is not understood universally by the general population. Many people also fail to realize that the symptoms of heart disease in women can be dramatically different than those for the same ailment in men.
Many hospitals are deciding the time is right to focus on women's cardiac health. While women's health programs have been part of hospital service lines for years and are showing steady growth, some healthcare providers are creating special centers that address women's cardiac health specifically. They tailor care for patients to focus on heart disease risk factors, with education a key component in delivering preventive strategies. That education is beginning to pay off.
"We're seeing an increase in recognition by women that heart disease is something that is much more likely to occur than any other form of disease, such as cancer," says Gretchen L. Wells, MD, PhD, who is director of the women's heart center at 885-licensed-bed Wake Forest Baptist Medical Center in Winston-Salem, N.C. "It's nice to see awareness increasing, but there are definitely gaps in knowledge among age groups and ethnicity of patients."
The lack of awareness includes patients and physicians, points out Kimberly A. Skelding, MD, director of women's heart and vascular health for Geisinger Health System in Danville, Pa. "After I spoke to a group of women on the topic, one woman came up to me and said, 'Oh my goodness, I have these complications you spoke of.' Light bulbs went off," recalls Skelding.
The Geisinger system includes the 545-bed Geisinger Medical Center campus in Danville, 547 beds at two other acute hospitals, and a rehab and nursing facility. "Women's cardiac problems present differently than [they do in] men, and it's not even known extensively in the cardiology community," Skelding says. "I'm only 15 years out of my general cardiology training, and I didn't have women's cardiac care as part of my training. This is something everyone needs to know about."
The most common heart attack symptom in women is chest pain or discomfort similar to what men experience, but women can have other symptoms, such as nausea, shortness of breath, and back or jaw pain, according to the American Heart Association.
The AHA has been pivotal in trying to change the conversation around women's heart health. Although much progress has been made in the "awareness, treatment, and prevention" of cardiovascular disease in women since the organization published its first clinical guidelines in 1999, the AHA states that "considerable challenges remain." Heart disease remains a major killer of women and, reversing a trend of the past four decades, death rates of women 35–54 years of age in the United States appear to be increasing, likely because of the impact of the obesity epidemic.
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