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Women First

Presentation
Women and men are physiologically different.  Hormones, genetics and smaller arteries and veins are several reasons women’s symptoms are different from men.   “Unlike men, women have more ‘atypical’ symptoms of coronary heart disease.  Although, the most common symptom for women is pain or discomfort in the chest, women can also have a heart attack without having any chest pain.  Other symptoms women might experience include shortness of breath, pain that runs along the neck, jaw, or upper back, nausea, vomiting, indigestion, unexplained sweating, sudden or overwhelming fatigue, or even dizziness,” says Dr. Shruti Boorla

Both doctors emphasized that women with diabetes or high blood pressure were especially at risk for not having a warning system.  “The good news” according to Dr. Parikh “is that many women don’t have severe uncomfortable pain like men. The bad news is women are more of a challenge in their assessment for potential heart problems.”

Diagnosis
Women with worrisome symptoms have often gone untested because of a medical bias.  If tested, it is often with stress echocardiograms that can miss disease. Drs. Boorla and Parikh are excited to offer the best in cardiology testing in their HeartFirst facility.  This includes nuclear stress tests as well as the “gold standard”,  known as Cardiac PET.  Gold standard denotes the best test to assess blood flow through blocked arteries.  These are the blockages that can cause symptoms and are treated to avoid heart attacks and sudden death.  Cardiac PET is only available in limited locations in North Texas.

We asked the doctors how they assess women who want to be screened for heart and vascular disease before they develop symptoms.  In addition to advanced lipid testing and screening blood tests, Drs. Boorla and Parikh recommend two inexpensive screening tests known as carotid intimal-medial thickening (CIMT) and coronary artery calcium score (CAC score). CIMT is a sound wave of the carotid arteries to identify the “age” of the artery and assess if the women needs further assessment and treatment.

Also available at HeartFirst is the state of the art, 128 Slice CT scanner, that can give you a coronary artery calcium score in ten seconds with minimal radiation and cost. This score helps your physicians quantify the amount of hard calcified plaque in the heart arteries.  CAC score has been recommended by the American Heart Association as the best way to screen women in the intermediate risk range for having a heart attack. You can quickly assess if you are at intermediate or high risk for heart attacks here.  

Some women wanting even more information about the health of their coronary arteries opt for a more advanced diagnostic test known as a coronary CTA. This is a 15 minute actual picture of your heart arteries, also done with the 128 slice Coronary CT scanner at Heart First.  This is the best test in cardiology to visualize soft AND hard plaque, as well as obtain percentage of any narrowing.  Coronary CTA is more than screening and often replaces the need to be hospitalized and undergo a potentially dangerous cardiac catheterization.

TREATMENT
Treatment for women is evolving daily and Drs. Boorla and Parikh are excited about keeping their patients up- to- date. Their primary focus is prevention.  “The biggest factors that contribute to heart disease are smoking, high blood pressure, high cholesterol, diabetes, family history and age,” states Dr Boorla. Although you can’t do much about your family history or your age, you can make lifestyle changes to avoid many of the other risk factors.  “Choosing a healthier lifestyle including a heart healthy diet, exercise, maintaining a healthy weight, and avoidance of smoking, will go a long way towards preventing heart disease,” says Dr. Parikh.

The doctors use their new screening tests to help answer the many excellent questions presented by their female patients.  Two examples include the use of aspirin and cholesterol lowering medications by women.  Women with normal CIMT or CAC score are at low risk and often do better from risk factor modification, and can avoid the potential side effects and cost of these medications.

RECOMMENDATIONS
Women who are at intermediate risk for heart disease, would benefit from a specially designed screening exam for women.  This WOMEN’S CARDIOVASCULAR HEALTH INITIATIVE, includes an EKG, CIMT and screening sound wave of the heart (echocardiogram).

This 30 minute evaluation is pain free and with out radiation, all for $99. Results will be called with in 48 hours and hopefully initiate an improved future for your cardiovascular health. Read more about the Womens' Cardiovascular Health Initiative.

Better yet, make an appointment to see Drs. Boorla or Parikh in consultation and find out how good it feels to work with a woman that understands your desires and needs.