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To determine what’s causing your symptoms, a doctor will take a careful medical history and give you a physical examination. If the doctor suspects an acute coronary syndrome, the following tests will be performed:

A doctor will give you a physical exam and ask about your symptoms and past health. He or she also will ask about your family’s health. You will have several tests to find out what is causing your symptoms.

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An electrocardiogram can show whether you have angina or have had a heart attack. This test measures the electrical signals that control your heart’s rhythm. Small pads or patches will be taped to your chest and other areas of your body. They connect to a machine that traces the signals onto paper. The doctor will look for certain changes on the graph to see if your heart is not getting enough blood or if you are having a heart attack.

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A blood test will look for a rise in cardiac enzymes. The heart releases these substances when it is damaged.
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In some cases, you might have a test called a cardiac perfusion scan to see if your heart is getting enough blood. It also can be used to check for areas of damage  after a heart attack.

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If tests confirm blood flow to the heart has been blocked, doctors will work quickly to reopen the artery.



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The heart is made mainly of special muscle. The heart pumps blood into blood vessels (arteries) which take the blood to every part of the body.
The coronary arteries supply oxygen-rich blood to the heart If these arteries are narrowed or blocked, the heart does not get enough oxygen.

This can cause angina or a heart attack. The blockage can be sudden and complete, or it can come and go – clot, break open, then clot again. “In either case, the heart tissue is dying, even if it’s just a few cells or a whole big section of the heart,” Bolger said.

Like any other muscle, the heart muscle needs a good blood supply. The coronary arteries take blood to the heart muscle. The main coronary arteries branch off from the aorta. The aorta is the large artery which takes oxygen-rich blood from the heart chambers to the body. The main coronary arteries divide into smaller branches which take blood to all parts of the heart muscle.

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Heart Attack Signs in Women

Uncomfortable pressure, squeezing, fullness or pain in the center of your chest. It lasts more than a few minutes, or goes away and comes back.

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Pain or discomfort in one or both arms, the back, neck, jaw or stomach.

Shortness of breath with or without chest discomfort.

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Other signs such as breaking out in a cold sweat, nausea or lightheadedness.

As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somehow more likely than men to experience these common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

Even though heart disease is the No. 1 killer of women, women often chalk up the symptoms to less life-threatening conditions like acid reflux, the flu or normal aging. Heart disease is the world’s biggest killers, accounting for a combined 15 million deaths in 2015. These diseases have remained the leading causes of death globally in the last 15 years.

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Angina in Women Can Be Different Than Men

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Angina (chest pain) is a warning sign of heart disease, and recognizing it and getting treated early may prevent a heart attack. Fatty build-up in your coronary arteries, called plaque, prevents blood flow that’s needed to provide oxygen to your heart muscle.

Women more frequently develop heart disease within the very small arteries that branch out from the coronary arteries – microvascular disease (MVD) and occurs particularly in younger women.

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On the other hand, Heart disease in men usually is due to blockages in their coronary arteries – obstructive coronary artery disease (CAD). Up to 50 percent of women with anginal symptoms who undergo cardiac catheterization don’t have the obstructive type of CAD.

You may have tightness, pressure or discomfort in your chest during physical activity or when stressed. But it goes away shortly after you stop the activity or get rid of the stress.

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Angina symptoms in women can also include feeling out of breath, nausea, vomiting, abdominal pain or sharp chest pain.  Once the extra demand for blood and oxygen stops, so do the symptoms.



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Your body gets most of its energy from glucose, a form of sugar that comes from some of the food you eat. If you have diabetes, it’s harder for your body to turn food into energy. That’s because the body either:

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cannot produce enough insulin (a hormone produced by the pancreas),

or both.

cannot use insulin (also called insulin resistance),

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Without enough insulin, glucose can’t enter the cells. Over time, the amount of glucose in your blood rises and cells are starved of energy. In addition to heart attack and stroke, uncontrolled diabetes can eventually lead to other health problems as well, such as blindness, kidney failure, and amputations.

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Heart disease & diabetes often occur together. Whether you have heart disease or are at high risk of it, get your blood glucose (sugar) level checked regularly, especially if diabetes runs in your family.

Diabetes

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  • 10.6 million women have diabetes (8 percent of all women ages 20 years and older)
  • 3 million women who have diabetes are undiagnosed.
  • 34.4 million women have pre-diabetes.
  • 14.6% of African-American women have diabetes.
  • 11.8% of Hispanic-American women have diabetes.
  • Prevalence for diabetes African American women is two times higher than in Caucasian women (14.6% of African-American women have diabetes while 6.1% of Caucasian women have diabetes)
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Heart Disease

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  • 43.8 million women are currently living with some form of cardiovascular disease. Nearly 7 million women have a history of heart attack and/or angina.
  • 6.6 million women are currently living with coronary heart disease (CHD).
  • Heart disease is the leading cause of death of American women and is responsible for 1 in 3 deaths in women annually.
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  • Diabetes dramatically increases a woman’s chances of developing heart disease and having a heart attack and at much younger ages.
  • Diabetes erases the heart protective benefits of estrogen during child-bearing years.
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Women with diabetes are up to five times more likely to develop heart disease than women who don’t have diabetes. Women with diabetes who have survived a heart attack are at much greater risk of having a second one compared to women without diabetes. Diabetes contributes to heart-related deaths.

Two out of three women with diabetes die from heart disease.

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While the death rate from heart disease has dropped by 27 percent in women without diabetes, deaths from heart and blood vessel disease in women with diabetes have increased by 23 percent over the last 30 years.

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Smoking doubles the risk for heart disease in people with diabetes.

2 out of 3 adults with diabetes report also having high blood pressure or taking prescription medications to lower their blood pressure.

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  • Women with diabetes are 2.5 times more likely to have heart attacks.
  • The risk for stroke is 1.5 times higher among people with diabetes.
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2 out of 3 adults with diabetes report also having high blood pressure or taking prescription medications

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Know Your (Diabetes) ABCs

Your health care team will focus on controlling your blood sugar levels and lowering blood pressure and blood cholesterol, together with use of aspirin and other medications as indicated.

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A

stands for A1C (a test that shows average blood glucose level over the past three months). Have this checked at least twice a year.

A1C target Below 7 percent

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B

is for blood pressure. High blood pressure is serious and can make your heart work too hard.
Blood pressure target Below 130/80 mm Hg

C

is for cholesterol (lipids). Have it checked at least once a year.

Blood fat (cholesterol) targets LDL (bad) cholesterol Under 100 mg/dL Triglycerides Under 150 mg/dL HDL (good) cholesterol For men: above 40 mg/dL For women: above 50 mg/dL

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Your doctor will ask you many questions about your symptoms and medical history. You will be asked about any conditions you have that may cause heart failure (such as coronary artery disease, angina, diabetes, heart valve disease, and high blood pressure). You will be asked if you smoke, take drugs, drink alcohol (and how much you drink), and about what drugs you take.

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You will also get a complete physical exam

Your doctor will listen to your heart and look for signs of heart failure as well as other illnesses that may have caused your heart muscle to weaken or stiffen.

Your doctor may also order other tests to determine the cause and severity of your heart failure. These include:

Blood tests

Blood tests are used to evaluate kidney and thyroid function as well as to check cholesterol levels and the presence of anemia. Anemia is a blood condition that occurs when there is not enough hemoglobin (the substance in red blood cells that enables the blood to transport oxygen through the body) in a person’s blood.

B-type Natriuretic Peptide (BNP) blood test

BNP is a substance secreted from the heart in response to changes in blood pressure that occur when heart failure develops or worsens. BNP blood levels increase when heart failure symptoms worsen, and decrease when the heart failure condition is stable. The BNP level in a person with heart failure — even someone whose condition is stable — is higher than in a person with normal heart function. BNP levels do not necessarily correlate with the severity of heart failure.

Chest X-ray

A chest X-ray shows the size of your heart and whether there is fluid build-up around the heart and lungs.

Echocardiogram

This test is an ultrasound which shows the heart’s movement, structure, and function.

The Ejection Fraction (EF) is used to measure how well your heart pumps with each beat to determine if systolic dysfunction or heart failure with preserved left ventricular function is present. Your doctor can discuss which condition is present in your heart.

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Electrocardiogram (EKG or ECG)

An EKG records the electrical impulses traveling through the heart.

Cardiac catheterization

This invasive procedure helps determine whether coronary artery disease is a cause of congestive heart failure.

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Stress Test

Noninvasive stress tests provide information about the likelihood of coronary artery disease.

Other tests may be ordered, depending on your condition.