Sunday, April 4, 2010
The gender line - coronary artery disease
Say what you will about Mars and Venus, but anatomically, male and female hearts look the same. When healthy, both should be about the size of a fist. Both have three main coronary arteries, the large blood vessels that wrap around the outside of the heart, supplying blood, oxygen and nutrients to keep each one pumping properly.
But when heart disease sets in, researchers are learning, gender can dictate major differences in how it actually develops and the parts of the heart it affects. These differences have implications for how heart disease is diagnosed — and treated. They may also change how doctors predict who is at risk for the most catastrophic of cardiac events, sudden cardiac arrest.
Men and women can have coronary artery disease in which those main, large arteries are plugged up by fatty, athlerosclerotic plaques. These blockages greatly increase the risk of a heart attack, sudden cardiac arrest, stroke and heart failure. But far fewer women show up with this "classic" form of heart disease.
"When it comes to acute heart attacks and sudden death [from cardiac arrest], women have these kinds of events much more often without any obstructions in their coronary arteries," says Dr. Amir Lerman, a cardiologist at the Mayo Clinic in Rochester, Minn.