The heart speaks volumes in February

Heart disease in women: It’s that common

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This month, it’s all about the heart – from the mushy cards and decadent chocolate sweets given on Valentine’s Day to heart-shaped silver lockets for keepsakes.

Hearts are prominent Feb. 14 and every other day in February, also known as American Heart Month with the first Friday of the month, Wear Red Day, calling attention to the prevalence of heart disease in women. More than 42 million American women are at risk of or have heart disease, the leading cause of death in women.

And women’s hearts, like a heart locket’s keepsakes, need to be cared for and protected.

The Hospital of Central Connecticut (HOCC) recognizes the high incidence of heart disease in women with its dedicated Women’s Heart Wellness Center, part of HOCC Department of Cardiology’s program that focuses on heart disease prevention, awareness and treatment for conditions affecting both men and women including heart failure, hypertension, cholesterol and irregular heart rhythms (arrhythmias).

By the numbers heart disease deaths in females accounted for 23.5 percent of deaths in 2010; cancer 22.1 percent and stroke 6.2 percent, according to the Centers for Disease Control and Prevention (CDC). It’s the leading cause of death in white and black females and just behind cancer for women of Hispanic, American Indian/Alaska native or Asian/Pacific Islander race.

HOCC cardiologist Dr. Heather Swales, FACC, director of the Women’s Heart Wellness Center, notes “a global lack of knowledge about women and how heart disease affects them.”

As for disease onset, men and women differ. While it can affect women of any age, coronary artery disease, also known as ischemic heart disease, typically affects women around age 60 – about 10 years later then it does men. Women appear to have a protective, buffer effect from the disease from natural estrogen, says Swales, but as estrogen wanes through menopause women’s heart disease numbers creep up. After menopause use of supplemental estrogen is associated with increased cardiovascular risk.

“Signs and symptoms of heart disease can be different in women so it’s important for women to see their primary care provider on a regular basis and talk about any problems they’re having,” says Swales, who stresses the importance of a healthy diet, regular exercise and avoidance of tobacco use and exposure.

Among the most common heart conditions affecting women, says Swales, are high blood pressure, heart failure and arrhythmias. Swales sees patients for these and other heart conditions at the Women’s Heart Wellness Center where female patients receive a gender-specific risk factor screening to address cardiac risk factors specific to women, a symptom assessment and physical exam.

A focus on keeping heartbeats in rhythm

Cardiologist Heather Swales holds a 3-D model of the heart.

Cardiologist Dr. Heather Swales holds a 3-D model of the heart

Like a steady drum beat, healthy hearts have a regular cadence, averaging 60-100 beats per minute at rest. But for about six million Americans who suffer from atrial fibrillation, the beats are too fast and not in rhythm.

The condition, which may include lightheadedness, trouble breathing or palpitations is the most common of several types of abnormal heart rhythms or arrhythmias.

Dr. Justin Lundbye, HOCC chief of Cardiology, says atrial fibrillation results from unorganized electrical activity in the heart. “It is generally speaking not dangerous,” he says.

However, patients that have it have about a five-fold increase in the risk of stroke because atrial fibrillation creates the right environment for the blood to form small clots that get expelled from the heart, causing strokes.

Atrial flutter, another type of arrhythmia, is marked by a fast yet often very regular heartbeat; and supraventricular tachycardia (SVT), is a fast heartbeat that originates in the heart’s upper chambers.

The most dangerous arrhythmias are ventricular tachycardia and fibrillation, each which causes the heart to quiver and makes it unable to pump enough blood to the body and brain, resulting in cardiac arrest, namely sudden cardiac death. First-line treatment for ventricular tachycardia and fibrillation is defibrillation to reverse the condition; patients also often benefit from an implantable cardiac defibrillator to shock the heart and convert it back to a normal rhythm when necessary.

Patients with arrhythmia may wear an event monitor to check for rhythm abnormalities, with results used to help determine the type of arrhythmia and appropriate treatment. Cardiac ablation is becoming the preferred first-line treatment for some arrhythmias, says Swales, but medications are still commonly used, too. During an ablation the pathways in the heart that trigger disruptive heartbeats are burned and eliminated.

For appropriate patients, HOCC cardiologists also work with Hartford Hospital electrophysiologists, cardiologists who specialize in arrhythmias, and conduct ablations at Hartford Hospital.

Treating high blood pressure and heart failure

High blood pressure is very common in both women and men with nine out of 10 women having it in their lifetime, says Swales.

Considered a “silent killer,” high blood pressure may show no symptoms but its risk factors aren’t hidden and include smoking, being overweight, a sedentary lifestyle, high-salt diet and excessive alcohol.

When your blood pressure is measured – and it should be done at least annually, says Swales -- two numbers are recorded – the top (systolic) number, that measures the pressure in the blood vessels when the heart squeezes to push the blood through your body; and the lower (diastolic) number, that measures the resting pressure when the heart is relaxed and filling with blood. Having high cholesterol can impact your blood vessels says Swales, which also leads to higher blood pressure readings. High blood pressure treatment includes medication and low-salt diets.

Another common condition, with a slightly higher incidence in women, is heart failure, affecting more than five million people in the U.S. according to the Centers for Disease Control. Heart failure is when the heart can’t pump enough blood to meet the body’s needs, resulting in a backup of fluid, says HOCC nurse practitioner Catherine Callan, APRN, CHFN, who manages the hospital’s outpatient Heart Failure Infusion Center and Heart Failure Resource Center. Heart failure symptoms include shortness of breath, swelling in the legs, cough, fatigue and abdominal fullness. Causes include heart disease, high blood pressure, valve disease and sometimes a viral illness.

Since opening of the infusion center, patients who previously would have been hospitalized for treatment now can visit the center on an outpatient basis. Frequency of visits depends on an individual’s medical needs.

Rounding out the hospital’s emphasis on cardiac care for women is the hospital’s membership with the WomenHeart National Hospital Alliance. WomenHeart: The National Coalition for Women with Heart Disease is the nation's only patient-centered organization serving women living with or at risk for heart disease and is dedicated to women's heart health through patient support, education and advocacy. HOCC is the first hospital in New England to be a founding member of the Alliance and holds monthly support groups.

Women need to talk about it more, share their stories, ask their questions and take control of the things they can control to reduce their risk factors,” says Swales of heart disease. “I think with centers like our Women’s Heart Wellness Center and the WomenHeart Support Network we’re making progress towards closing that gap.

Learn more about our cardiology services by visiting The Hospital of Central Connecticut's website.

Good to know:

In 2014 The Hospital of Central Connecticut was recognized nationally with three awards related to its cardiology and stroke programs. The hospital received the Get With The Guidelines® - Stroke Gold-Plus Quality Achievement Award and its Heart Failure Bronze Quality Achievement Award after implementing key quality improvement measures outlined by the American Heart Association (AHA)/American Stroke Association and American Heart Association/American College of Cardiology Foundation, respectively. In addition, the hospital received the American Heart Association's Mission: Lifeline® Bronze Plus Receiving Quality Achievement Award for implementing quality improvement measures to treat ST-elevation myocardial infarction (STEMI) heart attacks.

Cardiovascular and Interventional Radiology centralizing services

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With a patient-centered focus, The Hospital of Central Connecticut is renovating Department of Cardiology services at its New Britain General campus.

This fall all cardiovascular services, in addition to Interventional Radiology, will be on the campus’ ground floor.

“Unifying procedures and services into one central location will provide the patient with a better experience,” says Laura Labrecque, R.N., M.S.N., director of Cardiology. “It’s all about the patient and their family and how we can make this better and more efficient.”

All patient interaction — from registration to treatment, recovery and discharge — will stem from a single location within the hospital. With renovation, expected to be complete this fall, the department will provide:

• A central patient registration, admitting and waiting area; the waiting area is complete.

• West wing for the Catheterization Lab suite and Interventional Radiology, both now located on a lower level that will include a 10-bed holding area and three procedure rooms. Cardiac catheterization for diagnosis of blocked arteries and emergency angioplasty will continue to be available in this new location. Interventional radiology uses minimally invasive procedures to diagnose and treat conditions including hardening of the arteries (atherosclerosis), blood clots, fractured vertebrae and uterine fibroid tumors.

• East wing will support the combined cardiac clinic and testing area, which will increase from four exam rooms to seven. In addition the Heart Failure Infusion Clinic and Resource Center, also located in this area, will expand from one bay to three.

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