Historically, a health exam for women was focused on gynecology, but a shift — thanks in part to a concerted effort to raise awareness of heart disease in women — is taking place and the whole health of a woman is being screened.
Dr. Arasi Maran, an interventional cardiologist at the Medical University of South Carolina, has seen that change. She said doctors used to screen for “diseases of the bikini region,” such as breast cancer and cervical cancer, and helped their patients consider their birth control options.
“The other diseases didn’t get much thought. Now, it’s more of a comprehensive visit. It’s not just breast cancer, pap smears and contraception. Now, it includes blood pressure, body weight, cholesterol profile, diabetic and cardiovascular disease risk,” she says.
Maran says comprehensive “well woman visits” are ideally conducted by primary care physicians.
“A gynecologist sees a patient earlier, as a teen, but by the (patient’s) 20s, they should have a primary care physician.”
Even as a cardiologist, Maran is starting to nip problems before they become a tragedy with this approach. Of the 40 to 50 patients she sees weekly, one or two get a diagnosis of heart disease.
For more than a decade, the American Heart Association has been working to increase awareness of a disease which used to be considered only affecting men by designating February as “Go Red for Women Month.”
Heart disease is the No. 1 killer of women, causing one in three deaths each year or one woman every minute.
In advance of Go Red month, the association last week reiterated its assertion (via the journal, “Circulation’), that heart attacks in women have different causes and symptoms than men and that those differences make women’s heart attacks more deadly.
Worldwide, cardiovascular disease is the leading cause of death for women. In the United States, since 1984, heart attack survival has improved for women. But the heart death rates among women still outpace heart deaths in men, according to the association’s statement.
More specifically, the statement noted that plaque buildup in the arteries, a frequent cause of heart attack, can differ between the sexes. Women are less likely to need stenting to open a blocked artery, but they still suffer blood vessel damage that reduces blood flow to the heart, causing a heart attack.
Also, high blood pressure is a stronger risk factor for women than for men. And diabetes raises a young woman’s heart disease risk up to five times higher compared to young men.
Guideline-recommended medications are underused in women, compared to men, and women are referred less often for cardiac rehabilitation. When they are referred, they are less likely than men to go or to finish it.
For men and women, chest pain or discomfort is the most common heart attack symptom, but women are more likely to report shortness of breath, back or jaw pain, and nausea and vomiting.
Finally, black women of any age have a higher incidence of heart attacks than white women. And black and Hispanic women have more risk factors such as obesity, diabetes and high blood pressure at the time of heart attack compared to white women.
Regional offices across the country recruit women every year to tell their story to illustrate these facts.
Among the local ones this year is Shirley Woods Bickerstaff, 47, of Summerville, who was diagnosed with congestive heart disease years ago. When she moved here from Detroit in November 2012, she was in a wheelchair.
Shortly thereafter, Bickerstaff decided to seize control of her health, stopped consuming soft drinks, became a vegetarian and working out.
“I’m a Zumba nut,” says Bickerstaff, who has lost more than 100 pounds and been able to stop taking blood pressure medications.
More recently, Elaine Mincey, 56, of James Island, teetered on the edge of having a heart attack last summer.
After years of exhibiting symptoms more common in women — pain in her ear and jaw — and being misdiagnosed as having an allergy, her doctor realized it could be cardiovascular.
Even after that original suspicion on July 2, 2015, it wasn’t until July 31, that tests revealed she had blockages of 85, 95 and 100 percent in three arteries.
Cardiologists suspected a rare fourth artery, which she was born with, helped keep her alive.
Triple bypass surgery gave her a new lease on life and a desire to spread the word of cardiovascular awareness to other women.
“I had heart disease in both my mother and father’s families and I knew it would eventually catch up to me, but I thought it was going to be 70, not 55,” says Mincey, who says women need to make themselves aware of the risk factors and symptoms.
Not all the ambassadors will speak to matters of the heart.
Barbara Butler Jackson, now 59, did not have high blood pressure, diabetes or high cholesterol when she had three lacunar strokes on Nov. 8, 2012 that left her unable to speak and walk and in the hospital for 14 weeks.
“I was 56 years young and I am highly educated and had no clue what (would) have caused me to experience three strokes,” says Jackson, who had recently moved, like Bickerstaff, from Detroit to Charleston.
She traces the source of the stroke to a verbal dispute she had with a cousin, which left Jackson in tears.
Jackson says she has a family history of heart disease. Her father and grandfather died from massive heart attacks and her brother had open heart surgery at age 42.
Her emphasis is not only handling stress but knowing the signs of stroke and acting quickly.
“When I was in the hospital, I made a promise to God that if I recovered, I would teach others about strokes and that ‘time loss is brain loss.’ ”
Reach David Quick at 937-5516.