"Ask the Doctor": Women and Heart Disease

April 6, 2000

The Houston Chronicle presents "Ask the Doctor" where Dr. Susan Wilansky discusses health issues concerning heart disease, heart problems, arteries, diet, blood pressure, and women.

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HoustonChronicle: Welcome to Ask the Doctor! The purpose of the Ask The Doctor chats are to provide general information and is in no way intended to be construed as medical advice for any visitors' specific disease or condition. The intent is to increase a participant's knowledge about a general disease or condition. For treatment of your specific condition please see your personal physician. This forum is not intended to be used in emergency situations. If you are uncertain of the urgency of your problem or condition, contact your personal physician or the nearest hospital for assistance. Welcome to Ask the Doctor! HoustonChronicle.com, St. Luke's Episcopal Hospital - Houston and the Talk City Network are proud to present our special guests for today, Dr. Susan Wilansky of St. Luke's Episcopal Hospital. Welcome Dr. Wilansky!

Dr Wilansky: Thank you very much, it's my pleasure to be here today. The topic for discussion today is women and heart disease.

KALECHO1: I've heard that women are at less risk of heart disease than men. Is there an age when this risk factor evens out?

Dr Wilansky: That statement is very true, but is very age-dependent. The prevalence of coronary artery disease in women before menopause is significantly lower than men. About ten years after the menopause, women catch up.

Coffeebean: Is there a danger of heart problems if you are pregnant if there is a history of heart disease in your family?

Dr Wilansky: It depends upon what the history is. Generally, family history risk is coronary artery disease. Fortunately, fertile pregnant women are at very low risk for having coronary artery disease.

Jess1: Other than exercise and diet, what is the best way for a woman to protect her heart and her arteries?

Dr Wilansky: Exercise and diet are number one and number two. Maintaining a good body weight, normal blood pressure, and normal blood cholesterol levels would be the next three. Of course, avoidance of cigarettes is at the top of the list.

Daisygirl: What is Ventricular Septal Defect? How can it be repaired, and is it passed genetically?

Dr Wilansky: Ventricular Septal Defect is a hole in the ventricle septum, which is the portion of heart muscle that separates the right ventricle from the left ventricle. Depending upon its size, it can be surgically repaired with a patch. There is a genetic tendency to all forms of congenital heart disease. That is to say, heart problems with which one is born. Not all ventricular septal defects require surgical repair, particularly if they are small.

Sookie: Can pregnant women continue to take high blood pressure medicine?

Dr Wilansky: Pregnant women may take blood pressure medications, but this should be under the counsel of an obstetrician and/or a cardiologist. Many of the antihypertensive medicines are not safe in pregnancy.

MONALAZ: I would like to know what cardiomegaly is? Is it hereditary?

Dr Wilansky: Cardiomegaly is defined as a big heart. There are many etiologies for cardiomegaly. This phrase is often used on a chest x-ray report when in fact the heart may not be enlarged. An echocardiogram of the heart would clarify this issue. Because there are so many different etiologies, it is not possible to answer the question of genetics, or heredity.

Ramenmama: Is it true that taking an aspirin during a heart attack can help stop the attack? How does that work?

Dr Wilansky: Good question! Aspirin is a platelet antagonist. In other words, it opposes the action of platelets. A heart attack begins with a ruptured plaque, followed by platelets rushing to this site. This further encourages narrowing of the coronary artery. Aspirin interferes with this platelet rush. Taking an aspirin at the time of a heart attack may reduce its size.

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