Coronary Artery Disease In Women

What is coronary artery disease?

Coronary artery disease (CAD), or heart disease, occurs when arteries that supply blood to your heart become narrow or blocked. CAD is caused by plaque (cholesterol, fat, and other substances) that builds up in your arteries. Oxygen cannot get to your heart when your arteries narrow or become blocked, which may be life-threatening.

What increases my risk for CAD?

  • Obesity and lack of exercise

  • Age 45 years or older

  • High blood pressure or high cholesterol

  • Diabetes

  • Smoking

  • Certain medicines, such as birth control pills

  • Family or personal history of heart attack

What are the signs and symptoms of CAD in women?

You may not have any symptoms at first. Symptoms may begin slowly but increase quickly as plaque builds up in your arteries. You may not notice symptoms until the artery starts to become blocked. Women often do not have the common signs and symptoms that men tend to have. You may not have tingling in your arm or chest pain. You may instead have a tight, heavy, or burning feeling in your chest. You may also have any of the following:

  • Pain in your back, neck, stomach, or jaw

  • Shortness of breath, or a cough

  • Nausea or vomiting

  • Indigestion, heartburn, or loss of appetite

  • Fast, slow, or pounding heartbeat

  • Tiredness or trouble sleeping

  • Anxiety

How is CAD diagnosed in women?

CAD is often more difficult to diagnose in women than in men. Caregivers may need to use tests that include pictures of your heart working. You may be given contrast dye before some of the following tests to help caregivers see your heart better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • EKG: This test records the electrical activity of your heart. It is used to check for heart rhythm problems or an enlarged heart. It is also used to check for decreased oxygen going to your heart.

  • Exercise stress test with imaging: This test shows caregivers any blockages in your arteries. Caregivers use this test to watch changes in your heart while you exercise on a bike or treadmill. You may receive a stress test combined with an echocardiogram or an EKG.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your heart. The pictures may show blockages in your arteries. You may be given contrast dye for this test.

  • An echocardiogram is a type of ultrasound. Sound waves are used to show the structure and function of your heart.

  • MRI: This scan uses powerful magnets and a computer to take pictures of your chest. An MRI may show problems in your blood vessels. Do not enter the MRI room with anything metal. Metal can cause serious injury. Tell the caregiver if you have any metal in or on your body. You may be given contrast dye for this test.

  • Cardiac catheter: A catheter (tube) is guided into your heart through a vein in your arm, neck, or groin. Your caregiver may use an x-ray to guide the catheter to the right place. He may need to place a stent inside your artery during this procedure. A stent is a tiny tube that is inserted into your artery to keep it open and increase blood flow. You may be given contrast dye for this test.

Which medicines are used to treat CAD?

  • ACE inhibitors: These decrease your symptoms and slow your heart failure. You may need ARBs if you cannot take ACE inhibitors. ARBs help your heart beat more strongly.

  • Beta-blockers: These help your heart pump strongly and regularly.

  • Calcium channel blockers: These help make your heart beat at a regular rate and rhythm.

  • Cholesterol-lowering medicines: These may help reduce the risk of plaque buildup in your arteries.

  • Nitrates: These improve the blood flow through your heart.

  • Blood thinners: These prevent blood clots. They may make you bruise or bleed more easily. Use a soft toothbrush and an electric shaver to prevent bleeding.

  • Clot busters: This medicine helps break apart clots. It is given IV and may be given at the same time as other blood thinners. This medicine could save your life because blood clots in the heart, lungs or brain can kill you. Be careful because you may bleed or bruise easily.

  • Antiplatelet medicines: These help keep your blood from clotting and blocking blood flow in your arteries. Aspirin is an example of an antiplatelet medicine.

  • Diuretics: These help your body get rid of extra fluid and protect your heart from more damage. You may urinate more often while you are taking diuretics.

  • Blood pressure medicine: This is given to lower your blood pressure. A controlled blood pressure helps protect your organs, such as your heart, lungs, brain, and kidneys. Take your blood pressure medicine exactly as directed.

Which procedures are used to treat CAD?

  • Angioplasty: This is a procedure to open up an artery that has been blocked by plaque. A thin tube with a balloon on the end is threaded into your blocked artery. Once the tube is in the artery, the balloon is inflated and deflated until the artery stretches and opens. This packs plaque against the walls of the artery and improves blood flow through the artery. Your caregiver may decide to place a permanent tube called a stent inside the artery to keep it open.

  • Coronary artery bypass graft surgery: This is also called CABG. CABG is open heart surgery that is usually done if at least one of the arteries on your heart is blocked. Ask your caregiver for more information about CABG.

What are the risks of CAD?

You may develop chest pain because of the lack of blood flow to your heart. Your heart may beat too fast or too slow. The blood flow may be blocked completely. This can cause a heart attack or heart failure. This may be life-threatening.

What lifestyle changes do I need to make?

  • Cardiac rehab: Cardiac rehab is a program that may decrease your risk of heart damage and heart attack. You learn how to live a more heart-healthy lifestyle.

  • Exercise: Ask your caregiver about the best exercise plan for you. Exercise 30 minutes a day, at least 5 days a week if you can. This will help reduce the risk of heart damage or heart attack.

  • Quit smoking: It is never too late to quit smoking. Ask for information about how to stop smoking if you need help.

  • Maintain a healthy weight: Ask your caregiver how much you should weigh. Ask him to help you create a weight loss plan if you are overweight.

  • Eat healthy foods: Healthy foods include fruits, vegetables, whole grain breads, low-fat dairy products, beans, lean meats, and fish. Ask if you need to be on a special diet. Healthy foods will help you lose weight and may help improve your heart condition. It may also help lower the risk of heart attack.

  • Get a flu vaccine: This will help prevent infection with the flu virus, which can cause heart damage.

  • Limit alcohol: Limit alcohol to 1 drink a day. A drink of alcohol is 12 ounces of beer, 5 ounces of wine, or 1½ ounces of liquor.

How can I manage my CAD?

Follow your caregiver's treatment plan. This may include checking your blood pressure and blood sugar levels often. You may also need to visit your caregiver to have your cholesterol levels tested. Keep all your appointments. Write down your questions so you remember to ask them during your visits.

Where can I find support and more information?

  • American Heart Association
    7272 Greenville Avenue
    Dallas , TX 75231-4596
    Phone: 1- 800 - 242-8721
    Web Address:
  • WomenHeart The National Coalition for Women with Heart Disease
    818 18th St, NW, Ste 930
    Washington , DC 20006
    Phone: 1- 202 - 728-7199
    Web Address:

When should I contact my caregiver?

Contact your caregiver if:

  • You feel depressed or anxious.

  • You have nausea.

  • You have questions or concerns about your condition or care.

When should I seek immediate care?

Seek care immediately or call 911 if:

  • You feel pain or tightness in your back, neck, jaw, stomach, or arm.

  • You feel squeezing, pressure, fullness, or pain in your chest that lasts for several minutes or returns.

  • You have shortness of breath.

  • You feel lightheaded or suddenly begin to sweat at rest.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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