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Women especially at young age are experiencing an unprecedented increase in heart attacks and strokes. We attempt In this article to make the reader aware of the reasons for this.

How are women different from men for developing heart attack?

Women tend to develop cardiac disease 7-10 years later compared to men that is attributed to the protective effect of estrogen hormone, which is present till menopause.

What are the traditional risk factors for developing heart disease?

Both men and women are prone to develop cardiac problems if they have one or multiple risk factors listed below. They are called traditional because they have been in practice for the past 6 decades.

Non-modifiable risk factors Modifiable risk factors
·         Age

·         Male gender

·         Family history of cardiac disease (< 60 years)

·         Smoking

·         Diabetes

·         Hypertension

·         Hyperlipidemia

·         Obesity

 Despite the absence of many of these risk factors, women worldwide are increasingly dying due to cardiac ailments.

Do traditional risk factors confer a disparate risk for developing cardiac problems in women?

Women are sensitive than men for the development of heart diseases when they have associated traditional risk factors.

For example:

  • Diabetes: Women with diabetes have a 7-fold increase in cardiac events compared to only 3-fold increase in diabetic men.
  • Smoking and tobacco use has been shown to enhance the risk by an additional 25% in women compared to men for development of heart attacks. In fact tobacco use has been responsible for 50% of cardiac events in women and confers a 3-fold increased events. Normally women develop heart attacks 7-10 years later than men due to the protective benefits of estrogen hormone. This protective effect is lost with tobacco use and if they develop diabetes.

Unique risk factors for cardiac problems in female gender include: 

  • Pre-eclampsia (High BP during pregnancy associated with complications)
  • Diabetes during pregnancy
  • Polycystic Ovary syndrome
  • Early menopause
  • Autoimmune diseases

Early menopause and risk of heart attack:

 About 10% of women experience menopause naturally before the age of 45 years. This is called early menopause. Because of lack of estrogen in post menopausal women, it predisposes to cardiac events.

Compared to women of similar age, those who attain natural or surgical menopause (removal of uterus – Hysterectomy) less than 45 years are at 50% higher risk of developing heart attack and 20% increased risk of death.  Those women who attained surgical menopause tend to have higher cardiac events compared to natural menopause. So women should be dissuaded to undergo uterus removal surgery unless there is a clear evidence that the procedure is definitely required. Hormone replacement therapy has been tried to mitigate this risk but in vain. Current guidelines are against hormone replacement therapy for early menopause.

What can we do to prevent these cardiac events in women?

Targeting traditional risk factors – diabetes, hypertension, lipids, sedentary life styles, inappropriate food choices and obesity form the bedrock strategy for reducing the risk of developing heart attacks.

But for women further measures are needed to address the unique risk factors for women. The American College of Cardiology in its 2019 guidelines notified pre eclampsia, early menopause and autoimmune disease as “risk enhancers” for cardiac disease. They also added that physicians should have a low threshold to treat those patients with risk enhancers by life style measures and cholesterol lowering drugs to reduce the risk of developing heart attacks.

Finally women should realize that they are no longer at low risk for developing cardiac ailments and need to understand there are new risk factors that put them at “enhanced risk” for developing heart attacks.


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Cardiac catheterization is one of the most extensively performed cardiac procedures. If you have chest pain or irregular heartbeat, your doctor may recommend cardiac catheterization.

Cardiac catheterization is a minimally invasive procedure used to detect and treat cardiovascular diseases. This procedure involves the insertion of a catheter (a thin hollow tube) into the large arteries or veins present in the neck, arm or groin, which is then guided to the heart using a special X-ray. Once the catheter reaches the location, diagnostic tests or treatment procedures are carried out.

Why perform Cardiac Catheterization?

Cardiac catheterization is done to find the cause of the signs and symptoms of a heart problem or to treat or repair the heart damage.

This procedure is performed to:

  • Determine the pressure levels in the chambers of the heart.
  • Determine the heart function after a cardiac intervention.
  • Detect blockages in the coronary arteries (coronary angiography) or valve dysfunction.
  • Perform procedures such as angioplasty, ablation therapy or valve repair.
  • Obtain a small piece of heart tissue to examine under a microscope for detecting conditions affecting the heart muscle (cardiac biopsy).

What is the difference between Cardiac Catheterization and Coronary Angiography?

Catheterization is a procedure used to diagnose and treat various conditions. It involves the insertion of a catheter into the arteries and veins to reach the heart and to measure how much blood the heart pumps out, the pressure in each heart chamber, and to detect any defects in the heart. Also, various small instruments can be inserted into the catheter to view the interior of the blood vessels, to remove a tissue sample from the heart for further examination, etc.

Coronary angiography is a type of catheterization procedure, which involves analysing the arteries that supply the heart with oxygen-rich blood. This procedure involves the insertion of a catheter in the arm or the groin, which is threaded to reach the coronary arteries. During insertion, fluoroscopy (a continuous x-ray procedure) is used to guide the catheter to reach the precise position. After the catheter tip is at the right location, a contrast dye is injected into the coronary arteries. This dye can be seen on x-rays, and the outline of the arteries is viewed on a video screen.

How do I prepare for the procedure?

Inform your doctor about:

  • The medications that you are taking, especially blood-thinners or anti-inflammatory medications
  • Any medical conditions that you have
  • Allergies to any dyes or specific medications

Before the procedure:

  • Fast for at least 6 hours, as food and liquid increase the possibility of complications with general anaesthesia.
  • Empty your bladder before heading to the procedure.
  • Remove dentures and jewellery, as they may interfere with the imaging procedures.
  • Your general health status and vital signs will be monitored.

What happens during the procedure?

During cardiac catheterization, an IV cannula is inserted in your arm to administer medications. You will be given a mild sedative to help you relax during the procedure.

The general procedure of cardiac catheterization is given below:

  • The site of catheter insertion (usually the groin) is cleaned and shaved.
  • Usually, local anaesthesia is administered. General anaesthesia may be given before surgical procedures such as valve repair or ablation.
  • When the site of catheter insertion becomes numb, an incision is made, and the catheter is inserted using a catheter sheath.
  • Once the catheter reaches the heart, a dye is administered which outlines the vessels, valves and chambers of the heart.
  • The diagnostic tests or surgical procedures will then be performed for treating the condition.

Vital signs and electrocardiogram will be continuously monitored during the procedure.

Cardiac catheterization usually lasts for about 30 minutes. It may be longer if you are undergoing any other test or intervention using this procedure.

After the procedure is done, the catheter will be removed, and the incision will be closed by stitches. A sterile dressing will be used to prevent infection in the incision site.

What happens after the procedure?

Once the procedure is done, you will be asked to lie flat on the bed for 2-6 hours after the procedure. Your heart rate and blood pressure will be continuously monitored.

Once the anaesthesia wears off, you will be given pain medications. You will be asked to drink plenty of water to eliminate the dye that was administered. Usually, you will be asked to stay in the hospital for a few hours or a day.

After leaving the hospital, follow all the post-procedural instructions given by your doctor. You may resume your normal activities in a day’s time. Some soreness at the incision site is normal; it may reduce within a week.

What are the risks of Cardiac Catheterization?

Cardiac catheterization is a relatively safe procedure. However, like any other invasive procedure, some uncommon risks of this procedure are:

  • Infection
  • Blood clotting
  • Bruising at the incision site
  • Allergic reaction to dye
  • Arrhythmia
  • Air embolism
  • Stroke

Call your doctor if you experience:

  • Severe pain at the incision site
  • Signs of infection: redness, warmth, pus oozing or excessive swelling around the incision site
  • Numbness or tingling sensation in your limbs


Your heart needs to work 24/7 to keep your body systems working. Like any other body tissue, the heart too needs oxygen and nutrients to function efficiently. For this, we have a network of arteries that supply blood to the heart muscles which are called the coronary arteries. There are two chief coronary arteries:

the left and right coronary arteries, that branch out from the aorta near the point where the aorta and the left ventricle meet.

The right coronary artery supplies blood to the right atrium, the right ventricle, a small bottom area of the left ventricle and the back portion of the septum.

The left coronary artery supplies blood to the left atrium and ventricles and the front portion of the septum.

These coronary arteries give out various branches that supply blood to different parts of the heart.

Coronary artery disease:

When there is high level of unhealthy fats in the blood, they gradually start depositing in the insides of the coronary artery vessel wall and form a fatty plaque(atherosclerosis). This gradually narrows the lumen of the coronary arteries which obstructs blood supply to the heart. This condition is called as coronary artery disease. disruption of blood supply to the heart gives rise to a cluster of symptoms, the most important being chest pain or angina.

  • Warning signs of heart disease
  • Risk factors for heart disease
  • Possible complications of heart disease


There are an array of heart diseases but they do share some common symptoms. If you experience any of these symptoms, it is perhaps a good idea to get yourself tested. Check these out here:

  1. Angina or chest pain described as heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest.It is often accompanied by pain in the n the neck, jaw, throat, upper abdomen or back
  2. Shortness of breath
  3. Easy fatiguability
  4. Palpitation and rapid heartbeat
  5. Weakness/dizziness
  6. Sweating
  7. Nausea and vomiting
  8. Swelling in the lower extremities
  9. Fainting(syncope)
  10. Coughing and wheezing


For continuous circulation, the left and the right side of the heart must work together. Here are the series of steps that causes the blood to flow in the heart, lungs and body.

  • The right atria receives deoxygenated blood from two large veins- the superior and inferior venacava.
  • When the atria contracts and the blood passes from the right atrium to the right ventricle through the tricuspid valve.
  • When the ventricle fills, the tricuspid valve closes.
  • Next, the ventricle contracts and pushes blood to the pulmonary artery through the pulmonary valve.
  • The pulmonary artery carries the blood to the lungs where the blood gets oxygenated.
  • This oxygenated blood enters the left atria of the heart through the pulmonary vein.
  • Next, the left atria contracts and the blood flows from left atrium into your left ventricle through the open mitral valve.
  • When the ventricle is full, the mitral valve shuts,
  • Next, the ventricle contracts and oxygenated blood is passed to the aorta through which it is sent to various parts of the body.



Life is precious and to live life to the fullest, one should pay a little attention to his/her health- physical and mental. So, what do we do to be healthy- eat right and exercise, isn’t it? Actually, that isn’t it, though diet and exercise are very important for fitness but there is many more measures that we should take to keep ourselves healthy in and out. So, let us understand them one by one:

1. Let food be the medicine:

Ensuring that what goes inside your body is right- is the best thing you could do for your body. For a healthy heart, a 2000 calorie diet is recommended. Keep these points in mind:

  1. Eat at least 4.5 cups of vegetables and fruits a day
  2. At least two 3.5 oz. servings of fish per week, preferably oily fish
  3. At least three 1-ounce servings of fiber-rich whole grains per day
  4. Limit sodium intake to less than 1,500 milligrams a day
  5. Don’t drink more than 36 ounces/week of sweetened beverages

2. Let exercise be a part of your daily life:

All of us should spare atleast 30 minutes each day for exercise. Exercise doesn’t necessarily mean you should hit the gym, it means you need to keep your body moving- do brisk walk in the park, do yoga, or the best option would be, switch on your favorite music and groove on the beats.

3. Explore ways to be more physically active:

In addition to exercises, inculcating physical activity in your daily routine like using stairs instead of the elevator, parking your car further and walking down to office, using a manual bike to go to office, or having standing desks to work on.

4. Be a weightwatcher:

Obesity is a killer. You need to keep your weight in check. The best way to find out if your weight is just right is to measure the body mass index.The BMI calculation is very easy, divide your weight in kilograms by their height in metres squared. If your BMI is:

  1. below 18.5 – you’re in the underweight range
  2. between 18.5 and 24.9 – you’re in the healthy weight range
  3. between 25 and 29.9 – you’re in the overweight range
  4. between 30 and 39.9 – you’re in the obese range

5. Check your health numbers:

Go for regular health checks. Remember these numbers:

  1. Blood pressure < 120/80
  2. Fasting blood sugar< 100 mg/dL
  3. Total cholesterol < 200 mg/dL

6. Smoking:

Smoking is one of the chief risk factors for not only heart disease but also deadly cancers, lung diseases and chronic disorders like high blood pressure. Quitting smoking is one of the best gift that you could give your body today.

7. Switch off your stress mode:

People with stress and mental illnesses like depression are at greater risk of heart diseases. Have a good social life, spend time with friends and family, explore new places, give some time to your hobbies and interests- do anything that relaxes you. A relaxed mind and body makes you a more productive person and helps you stay healthy.

8. Laugh your way to health:

Research suggests laughing lowers stress hormones, decreases inflammation in your arteries, and raises good cholesterol levels.












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