Women’s heart health is less well taken care of than men’s. Cardiologist Claire Mounier-Vehier, founder of the association “Acting for women’s hearts”, explains why, and above all how to remedy this problem.
– Why doctor – Do women die of heart problems more than men in France?
Professor Claire Mounier-Vehier – There are 200 women who die a day in France from cardiovascular diseases (stroke, heart attack, aortic pathology), which is enormous. This is 6 times more than breast cancer, for example.
In absolute terms, there are three times more heart attacks in men than in women. But affected women have a mortality at thirty days and at one year twice as high as in men. Women also have more sequelae, such as heart failure, serious ventricular rhythm disorders with defibrillator, or fatigue following exertion.
– How can these disparities between the two sexes be explained?
There are several explanations. First, there is under-screening for heart problems in women. Then, women are slow to react, because the symptoms of their heart problem are, half of the time, atypical. They don’t necessarily think of the heart, and arrive later* than men at the hospital, with more diffuse lesions and arteries that are more difficult, if not impossible, to revascularize. Women don’t get enough rehabilitation either. Finally, the traditional risk factors (tobacco, stress, physical inactivity, precariousness, obesity, diabetes, hypertension, etc.) are more harmful in a woman’s coronary than in a man’s coronary.
– What signs should alert women to a possible heart problem?
Fatigue, shortness of breath on exertion, pain between the shoulders or in the breasts, nocturnal awakenings, paresthesias in the arms and hands, difficulty breathing or digesting, palpitations, nausea and vomiting may be symptoms of a heart problem and should lead to consultation. The recurrence and increase in the duration of the symptoms constitute an additional alarm signal.
– Are there emerging risk factors for women’s hearts?
Healthy heart function in women can be threatened by several emerging risk factors:
– Contraception with synthetic estrogen.
– Late pregnancies*.
– PMA techniques (medically assisted procreation).
– Valvular heart disease and cardiomyopathies unknown, which are developing especially among Algerian and African women.
– Menopause, which removes hormonal protection (women have a risk of heart attack which disappears within five years of stopping menstruation).
– Chronic inflammatory diseases, which affect women more.
– Endometriosis.
– How were these emerging risk factors identified?
New cardiac risk factors in women are being identified thanks to the development of cardio/gynecology, which originated in the United States. Today, cardiologists and gynecologists are working more together, and this sharing of knowledge has made us realize that the weight of hormonal risk factors is very important in female heart problems.
– Should we continue to treat traditional risk factors in women?
Sure.
– Should doctors change their approach to women’s heart problems?
Yes, because there are big gaps in knowledge among some doctors – it’s a generational and very gendered phenomenon. They must therefore be trained so that they can detect the atypical symptoms of female heart problems, which is not always the case.
– Is “gender medicine” progressing in your field?
We are making progress on gender medicine, but slowly, because changing a doctor’s professional practices is complicated. Many are however seeking training, and young practitioners are better trained in women’s bodies.
– What advice do you have for women to take care of their heart health?
They must first be trained in prevention, the potential heart problems they may encounter and the associated symptoms, which they can do on site Actingfortheheartofwomen.com. They also need to listen to each other and not minimize their symptoms. Finally, if they have any doubts about their doctor’s diagnosis, don’t hesitate to ask for a second opinion.
*Women will take between 30 minutes and 7 days to be taken care of following a heart problem.
*Cardiovascular diseases have become the leading cause of preventable maternal mortality (66% of cases occur during pregnancy or the year following childbirth).
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