MENDING MATTERS OF THE HEART FOR WOMEN, CARDIAC PROBLEMS CAN BE HIDDEN OR MISDIAGNOSED.Byline: Diana McKeon Charkalis Lifestyle Editor Lori Kupetz looks younger than her 40 years, especially when she hula-hoops in front of her Sherman Oaks home with daughters Sophie, 9, and Zoe, 7. No one would ever guess that earlier this year, this thin vegetarian who doesn't smoke underwent a triple bypass. ``I just don't fit the bill of someone who would have heart surgery,'' says Kupetz, who is now out to spread the word about cardiovascular disease Cardiovascular disease Disease that affects the heart and blood vessels. Mentioned in: Lipoproteins Test cardiovascular disease from a female perspective. ``But heart disease kills women more than anything else. It's not just a man's disease.'' And sadly, for many women, it often goes unnoticed. ``It's very tragic, but unfortunately two-thirds of women will actually die of heart disease and not know they have a problem,'' says Dr. Lisa Matzer, medical director of Glendale Adventist Medical Center's Outpatient Cardiac Services Program. Doctors and researchers say this is partly because heart disease affects men and women differently. ``The symptoms women present are a lot different than the symptoms we typically see in men,'' says Matzer. She says the most common for women include weakness, fatigue, shortness of breath Shortness of Breath Definition Shortness of breath, or dyspnea, is a feeling of difficult or labored breathing that is out of proportion to the patient's level of physical activity. with exercise and just not feeling right. In addition, tests that work for men aren't always as effective for women. ``Making the diagnosis of heart disease can be difficult,'' Matzer says. ``The angiogram an·gi·o·gram n. An angiographic x-ray of blood vessels used in diagnosing pathological conditions of the cardiovascular system.//An x-ray of one or more blood vessels produced by angiography and used in diagnosing pathology in the cardiovascular is the gold standard for men, so we assume it's the gold standard for women. But it only works for one-third of women. We know that two-thirds of women (with heart problems) will go in and be given a clean bill of health a certificate from the proper authority that a ship is free from infection. See also: Clean .'' For Kupetz, too, getting the right diagnosis proved elusive. Her story began in February 2005. One day while hiking with a friend, she found herself doubled over with chest pains. After two more similar episodes, she called her internist. In light of her family history of heart attacks combined with her own high cholesterol Cholesterol, High Definition Cholesterol is a fatty substance found in animal tissue and is an important component to the human body. It is manufactured in the liver and carried throughout the body in the bloodstream. level, he recommended she see a cardiologist. `` `Doctor, I'm having the pains right now,'' ' Kupetz said in the cardiologist's office, while taking a standard stress test on a treadmill. But he couldn't see any abnormalities, so he diagnosed her chest pains as non-cardiac-related and sent her to a gastroenterologist. The pattern continued. Nearly one year, four doctors and seven major tests later, Kupetz didn't have answers. And she was still getting chest pains from everyday activities like dancing with her kids or bringing in groceries. She had stopped exercising. One doctor suggested she take antidepressants Antidepressants Medications prescribed to relieve major depression. Classes of antidepressants include selective serotonin reuptake inhibitors (fluoxetine/Prozac, sertraline/Zoloft), tricyclics (amitriptyline/ Elavil), MAOIs (phenelzine/Nardil), and heterocyclics . Matzer hears this a lot. ``You go into my waiting room and ask who has a Valium and they all raise their hands because they've been told they have a psychological problem. But it's not all in their head. It's all in their heart.'' Kupetz finally found answers when she called Dr. C. Noel Bairey Merz, medical director of the Women's Health Women's Health Definition Women's health is the effect of gender on disease and health that encompasses a broad range of biological and psychosocial issues. Program, Preventive and Rehabilitative Cardiac Center, at Cedars-Sinai Medical Center Cedars-Sinai Medical Center is a world-renowned hospital located in Los Angeles, California. History Cedars-Sinai is the result of a merger in 1961 between two major Los Angeles hospitals, Cedars of Lebanon and Mount Sinai Home for the Incurables, with Steve Broidy as in Los Angeles. Confident that Kupetz did indeed have a heart problem after hearing her story, Bairey Merz ordered an echocardiac stress test and an adenosine adenosine /aden·o·sine/ (ah-den´o-sen) a purine nucleoside consisting of adenine and ribose; a component of RNA. It is also a cardiac depressant and vasodilator used as an antiarrhythmic and as an adjunct in myocardial perfusion imaging cardiac stress MRI 1. (application) MRI - Magnetic Resonance Imaging. 2. MRI - Measurement Requirements and Interface. . Both showed that Kupetz's heart was not responding as it should. A subsequent angiogram found three arteries with major blockages. After an attempt at angioplasty, Kupetz had triple-bypass surgery in March. Through it all, her family, especially Daniel, her husband of 12 years, was by her side. Kupetz credits Bairey Merz with saving her life, but the doctor says Kupetz deserves praise, too. ``Lori was a positive advocate for herself. She didn't stop pursuing it or ignore her symptoms. Doctors can only do so much. They need active partners in the process.'' Bairey Merz continues to keep track of her patient's health and Kupetz does her part by maintaining a regimen of statin drugs, beta blockers Beta Blockers Definition Beta blockers are medicines that affect the body's response to certain nerve impulses. This, in turn, decreases the force and rate of the heart's contractions, which lowers blood pressure and reduces the heart's demand for , aspirin and prescribed doses of fish oil. Kupetz's pain, triggered by insufficient blood flow to her heart, is finally gone. The only visible sign now is a scar on her collarbone col·lar·bone n. See clavicle. . Recently while she was getting dressed, her daughter protested when she tried to hide it with a high collar. ``Every scar has a story,'' her daughter told her. ``And you should be proud of yours.'' Diana McKeon Charkalis, (818) 713-3760 diana.charkalis@dailynews.com Women, ask your doctor When visiting the doctor, sometimes women's heart health problems may be overlooked. Asking physicians specific questions can help get a useful discussion started. Here's a list to bring to your next office visit: What is my risk for heart disease? What is my blood pressure? What does it mean for me and what do I need to do about it? What are my cholesterol numbers? (These include total cholesterol, LDL LDL - ["LDL: A Logic-Based Data-Language", S. Tsur et al, Proc VLDB 1986, Kyoto Japan, Aug 1986, pp.33-41]. , HDL (Hardware Description Language) A language used to describe the functions of an electronic circuit for documentation, simulation or logic synthesis (or all three). Although many proprietary HDLs have been developed, Verilog and VHDL are the major standards. , and triglycerides Triglycerides Fatty compounds synthesized from carbohydrates during the process of digestion and stored in the body's adipose (fat) tissues. High levels of triglycerides in the blood are associated with insulin resistance. , a type of fat found in the blood and food). What do they mean for me and what do I need to do about them? What is my ``body mass index'' and waist measurement? Do they mean that I need to lose weight for my health? What is my blood sugar level, and does it mean I'm at risk for diabetes? If so, what do I need to do about it? What other screening tests for heart disease do I need? What can you do to help me quit smoking? How much physical activity do I need to help protect my heart? What is a heart-healthy eating plan for me? How can I tell if I may be having a heart attack? If I think I'm having one, what should I do? -- NIH/National Heart, Lung and Blood Institute CAPTION(S): 4 photos, box Photo: (1 -- cover -- color) ROUND AND ROUND Challenges of diagnosing heart disease in women (2) Lori Kupetz of Sherman Oaks has no problem playing with her children, Sophie, 9, left, and Zoe, 7, after undergoing triple-bypass surgery earlier this year at the age of 39. For months before her operation, doctors did not see her problem as heart-related. (3) Spending time being active with daughters Sophie, left, and Zoe, right, is high on Kupetz's list since bypass surgery Bypass surgery A surgical procedure that grafts blood vessels onto arteries to reroute the blood flow around blockages in the arteries (arteriosclerosis). increased blood flow to her heart and stopped the regular chest pains that led her to curtail any strenuous activity. (4) Kupetz saw four doctors and had seven major medical tests before her heart disease was diagnosed. Before then, physicians attributed her symptoms to, among other things, gastroenterological problems and depression. Box: Women, ask your doctor (see text) |
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