Katy Lonergan, M.D. Answers Questions On: Heart Disease

I treat patients with various cardiac complaints, coronary artery disease, congestive heart failure, and heart valve disease. I assess their cardiac risk using ultrasound and other imaging tools.

I have a particular interest in women’s cardiac health because their cardiac symptoms may manifest differently than in men. Prevention and treatment of heart disease in women is crucial because it is the leading cause of death in women in the United States. Post-menopausal women are at higher risk, but pre-menopausal women should still be aware of their risk.

Although men and women can both suffer from typical cardiac symptoms, women may describe them differently or even experience them differently. To effectively diagnose heart disease in women, I’ve learned to be open-minded about the way women explain their symptoms.

Women tend to develop heart disease later than men by about a decade. By the time it’s diagnosed in women, it is sometimes more severe because it has already been going on for a while.

Yes, they have the same risk factors: High blood pressure, diabetes, high cholesterol, smoking, and a family history of heart disease are the big five.

There are other conditions that also increase cardiovascular risk, such as obesity and lack of physical activity. We’re also learning more about obstructive sleep apnea as a risk factor for heart disease.

There’s always something we can do to help lower patients’ cardiovascular risk, and the first step is to educate them about how to prevent heart disease and then develop strategies to help them follow those recommendations.

First, they should be screened for high cholesterol, diabetes, and other risk factors.  Lifestyle and exercise are also important. I like to give my patients an exercise “prescription,” which tells them what exercise strategy may lower their risk of high blood pressure, diabetes, and heart disease.

A poor diet worsens the risk, so nutrition is a big factor as well. You don’t prevent heart disease in six or 12 months. You do that over decades, before it ever has a chance to develop. So people in their 20s, 30s, and 40s should be thinking about lifestyle choices that will lower their risk 10 or 20 years down the road.

Pregnancy places significant stress on a woman’s body, especially on the heart. Many heart conditions are well-tolerated during pregnancy, but there are some for which pregnancy is significantly risky.

A woman with prior heart disease who is considering pregnancy should first be properly evaluated by her primary doctor, obstetrician, or cardiologist and then plan the pregnancy appropriately.  

Sometimes women without a history of heart disease will develop cardiac symptoms during pregnancy. Palpitations, dizziness, and fainting are common. These can sometimes be part of a normal pregnancy, but symptoms should be discussed with your obstetrician and it may be helpful to have a cardiologist’s opinion.