• Diagnosis of Heart and Vascular Disease in Women


    Gauging overall risk for cardiovascular disease is a challenging proposition, especially for women who have multiple risk factors to test for and monitor. Whether you are a woman or a man, it is best, if possible, to work with your doctor and other healthcare providers to manage your risks and stay on track with your goals for a heart-healthy lifestyle.  

    Know Your Risk Factors

    Do you get a mammogram every year? That's very important. But what are you doing to check on your cardiovascular system? Depending on your risk factors, your primary care physician or cardiologist may recommend certain tests. It's always important to check your blood pressure and cholesterol, but it becomes especially important for women after menopause, even if you've never had any symptoms of cardiovascular disease.

    Do you know your cholesterol levels? The current government guidelines for the ideal LDL (bad) cholesterol level is 100mg/dL or below, especially if you have risk factors such as high blood pressure, are overweight,or have a family history of heart disease. The target HDL (good) cholesterol level is above 50 mg/dL for women.

    Do you know your blood pressure? Your blood pressure should not go above 140/90 mmHg for long periods of time.

    Tests for Cardiovascular Disease

    If you are concerned about your risk factors and especially if you have noticed any warning signs for heart attack or symptoms of stroke, seek help immeidately. These are medical emergencies that require immediate attention. .

    Several tests may be required to determine your risk of heart disease. These tests include:

    Sometimes Tests Don't Spot All Forms of Cardiovascular Disease

    Men and women get heart disease, but how they get it and the best way to treat it may be different. Researchers are only beginning to understand some of these differences. In the Women’s Ischemia Syndrome Evaluation (WISE) study, for example, researchers found that a traditional diagnostic test for heart disease - an angiogram - may not identify a condition that is more common in women, called microvascular disease (dysfunction of the tiny blood vessels that supply the heart muscle with blood).

    Because microvascular disease is an emerging area of research, there is not yet a strong consensus on how it should be best diagnosed. Broadly speaking, your cardiologist may diagnose you with microvascular disease if you have the following:

    • Chest pain (also known as angina) during routine activities
    • Known risk factors for heart disease, such as diabetes, high blood pressure (hypertension), obesity, smoking, a family history of heart disease, etc.
    • An angiogram that may not show blockages in major bloods vessels of the heart but a stress test that indicates reduced blood flow to the heart

    Research on coronary microvascular disease is ongoing and is expected to provide helpful information the best ways to diagnose and treat it. If you would like to talk with your doctor about microvascular disease, here are some good questions to help you get started.