By Anna Horner | News & Views
Heart disease is the leading cause of death among women, and young women recovering from heart attacks often experience worse outcomes than their male counterparts. This makes it important for cardiac rehabilitation (CR) professionals to understand the different mechanisms for heart attacks in women and the impact of pregnancy on the heart in those with pre-existing cardiovascular conditions.
In an AACVPR live webinar on February 15, Nandita Scott, MD, FACC, FASE, cardiologist and Director of the Women’s Heart Health Program at Mass General Brigham, explored the sex-specific differences in cardiovascular care and the important role they play in the diagnosis, treatment and management of cardiovascular disease in women. She also discussed alternate mechanisms of heart attack in women. “The typical mechanism for myocardial infarction is plaque buildup,” Dr. Scott explained in an interview ahead of the livestream. “However, there are other mechanisms in play that have been underappreciated over time, especially in women. This includes coronary spasm, small vessel disease and coronary artery dissection. If you don't know what you're treating, then sometimes this can explain why women have worse outcomes.”
The webinar also aims to help CR professionals better understand the cardiovascular hemodynamic burden of pregnancy. “Women are entering their pregnancies older, with higher incidence of multifetal pregnancies and with pre-existing cardiovascular issues,” Dr. Scott said. “Maternal mortality in the U.S. is actually rising over time, and the No. 1 cause of death during pregnancy is heart disease. Given the burden on the heart during pregnancy, it is pretty amazing when you think about all the women who go through pregnancy without issue, but if you have pre-existing heart disease, then the heart is really stressed when you become pregnant.”
CR professionals who attended the webinar or watch the recording will gain a better understanding of sex-specific differences in heart health and how to apply this knowledge to their exercise prescriptions. “In particular, we're going to talk about coronary artery dissection, which is now being better recognized as a form of heart attack,” said Dr. Scott. “Those patients often are treated like they have plaque and are restricted, but they're usually very healthy younger women who want to get back to what they were doing. Learning that we need to individualize their exercise regimen to meet their needs is important.”
The livestream event has ended! Please check back for availability of the webinar recording, "Heart Disease in Women," which will be offered at no cost to AACVPR members.