Do You Have ‘Hidden’ Heart Disease?

If so, some changes are in order—and it’s not just about looking better in a bathing suit!

What the Researchers Found

“We’ve known for some time that hidden heart disease exists, but didn’t realize how common it is until the findings of a major study were published recently,” says cardiologist Deborah Sundlof, D.O. The study, called WISE, included 936 women with symptoms that led their doctors to order angiograms. Only a third had obvious blockages—but more than half the women without blockages turned out to have hidden heart disease.

The chest pain, the ED, the tests for a blockage, the artery-opening procedure. It’s the classic heart-attack scenario—for a man. But researchers have found that heart disease can look very different in a woman, so different it may never be diagnosed.

According to the latest research, as many as 3 million American women may have 'hidden' heart disease, or microvascular syndrome. Plaque builds up evenly in the small arteries of the heart rather than forming major blockages. Chest pain is the main symptom, but nothing shows up on an angiogram, the most common X-ray test for coronary disease.

“The condition is dangerous because it reduces blood flow to the heart,” says cardiologist Deborah Sundlof, D.O., of Lehigh Valley Hospital and Health Network. “The arteries aren’t able to dilate as they should when the heart muscle needs more oxygen.” You’re at increased risk for heart failure or a heart attack, but you don’t know it because your arteries appear fine on the X-ray.

There’s no simple way to diagnose hidden heart disease, says Sundlof’s colleague, family physician Jennifer Derr, D.O. “A stress test may be helpful, and we look closely at risk factors including overweight, smoking, diabetes, high cholesterol, high blood pressure, inactivity and family history.”

Why is it important to know if you have the condition? “Knowledge is power,” Derr says. “It motivates you to make lifestyle changes and to get to the ED immediately if you have chest pain.”

That’s not the only clue to a heart attack. For women, the more common heart attack symptoms are extreme fatigue, indigestion, or chest discomfort with lightheadedness, sweating or shortness of breath. If you have any of them, call 9-1-1 and chew an aspirin tablet. “Don’t be embarrassed if it turns out to be something else,” Sundlof says. “It’s better to be safe.”

Meanwhile, if you haven’t had a 'heart-to-heart' with your doctor, do it now. “Be blunt—ask about your risk factors, what tests you need and what changes you should make,” Derr says. “Many of my patients are more motivated to lose weight for their appearance than for their cardiovascular health. This isn’t about how you look in a bathing suit, it’s about preventing a heart attack!”

Want to Know More about hidden heart disease and women’s heart health? Click here.

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