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Hidden Epidemic: Heart Disease in America
Take One Step: A PBS Health Campaign
Hidden Epidemic: Heart Disease in America + Take One Step for a Healthy Heart with Larry King  

Watching: Take One Step for a Healthy Heart with Larry King

Chapter 2 - What Women Need to Know [2:36]

The panel explains how heart disease often produces different symptoms in women than men.

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Transcript: Chapter 2 - What Women Need to Know

The panel explains how heart disease often produces different symptoms in women than men.

LARRY KING: Women have more of a problem with heart disease than with breast cancer, right, Dr. Johnson?

DR. PAULA JOHNSON: Absolutely.

LARRY KING: Is it trickier to diagnose a woman?

DR. PAULA JOHNSON: It is trickier. And some of the standard tests we use, such as a standard treadmill test, don't work as well in women.

LARRY KING: Why?

DR. PAULA JOHNSON: Well, it's not totally clear. It may be that especially for women with estrogen that it does something to the electrocardiogram tracing that gives you false positive rates. So there are many women out there, including diabetics, who do need stress test with what we call imaging or special ways to take pictures of the heart.

The other interesting thing is, though, that when you do get a positive test in some of these more sophisticated tests, the kind of gold standard catheterization that gives us pictures of the arteries may not work as well in women, given that they have potentially different types of diseases: small vessel disease or disease that are of long parts in the artery.

DR. PAULA JOHNSON: The good news is that we now have technology that allows us to look inside the artery and to also measure flow so that we can make these diagnoses in women.

LARRY KING: I'm also told, Dr. Legato, that very often a woman in a doctor's office saying she has a chest pain will be sent home with Pepto-Bismol. A man will be given an EKG.

DR. MARIANNE LEGATO: Correct.

LARRY KING: Why?

DR. MARIANNE LEGATO: Especially because one out of five women when they're actually even having a heart attack don't have classic symptoms. I heard you before saying your pain was in the arm and excruciating. Did you have the elephant on your chest too?

LARRY KING: No.

DR. MARIANNE LEGATO: Women, one out of five will have what they think is indigestion, pain in the upper abdomen or back. But the clue is they're intensely nauseated. They hyperventilate. They're very hungry for air. And they have a soaking sweat. And it's a constellation that isn't recognized.

DR. STEVEN NISSEN: We've been working hard at increasing awareness among women. The Hard Truth campaign launched by the National Heart, Lung and Blood Institute is designed around this Red Dress campaign to increase awareness. We've come a long way but we've got a long way to go yet.

LARRY KING: Shouldn't there be awareness among doctors too?

DR. STEVEN NISSEN: Absolutely. You bet.

DR. MARIANNE LEGATO: There has been a lot of attention given to breast cancer, as we all know. It attacks a younger population. And it's true that coronary artery disease is delayed by ten years in women and we usually only have an equal vulnerability at about the age of 60. We ought to know that and we ought to know that more women die than men of this illness and that cardiovascular disease kills more women than all cancers combined. So I think that's a very important thing for women to know.

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