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Here’s what you need to know if you’ve been diagnosed with cardiovascular disease

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Ask your doctor to evaluate you before resuming sexual activity.

If you’ve had heart failure or a heart attack, cardiac rehabilitation and regular physical activity can reduce the risk of complications related to sexual activity.021.

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If you’re thinking about starting birth control or getting pregnant, be sure to talk to your doctor first.

Don’t skip the medications that could improve cardiovascular symptoms because you’re concerned they could impact your sex drive or function. Your heart health should come first!

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If you’re a post-menopausal woman with cardiovascular disease, it’s generally safe to use estrogen that’s topically or vaginally inserted for the treatment of painful intercourse.

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Women & Atrial Fibrillation

What is Afib?

Have you ever felt your heart flutter, race or skip a beat? Most of us have at some point, But if this happens more frequently, you may have atrial fibrillation.
Atrial fibrillation (Afib) is a problem with the heart’s rhythm – the way it beats. When someone is “in Afib,” the heartbeats in a rapid, chaotic way.

What are some of the signs & symptoms?

Have you ever felt your heart flutter, race or skip a beat? Most of us have at some point, But if this happens more frequently, you may have atrial fibrillation.
Atrial fibrillation (Afib) is a problem with the heart’s rhythm – the way it beats. When someone is “in Afib,” the heartbeats in a rapid, chaotic way.

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very rapid or irregular heartbeats – some women say they feel their heart flip-flopping in their chests, skipping a beat or fluttering

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Listen to your body, Afib can occur every once and a while (called paroxysmal atrial fibrillation) or all the time (chronic atrial fibrillation).

Either way, be sure to tell your health care provider about all of your symptoms.

Millions of Women live with atrial fibrillation (Afib). Even though it is more common in men, women with Afib are more likely to have a stroke. Untreated, Afib can also lead to heart failure and chronic fatigue.

Risk factors:

Afib is more likely as you get older. On average, women tend to develop Afib around 75 years of age (vs 67 for men). However, younger women can also have it. Other risk factors can include:

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How is Afib diagnosed?

Your doctor will first ask how you have been feeling and perform a physical exam. If you’ve noticed chest pains, breathlessness or a racing heart, be prepared to tell him or her when they happen (laying down, climbing stairs, etc.) and how often.

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There are a number of things you can do to live well with Afib and prevent problems.

A

Pay attention to risk factors for Afib, heart disease and stroke. Make sure your blood pressure and cholesterol levels are stable.

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B

Eat a healthy diet.

C

Exercise regularly and monitor your weight.

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D

Know what triggers an episode. Doing so will help you prevent or better anticipate Afib.
Common risks that triggers an AFib episode: alcohol, caffeine, upper respiratory infections and extreme stress.

E

Learn how to pace yourself. Most women living with Afib will tell you it is a livable condition

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F

Have a plan to stay calm. Anxiety can make episodes much worse.

G

Take your medications as prescribed.

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H

Know your risk of stroke & other health problems

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Possible treatments include lifestyle changes and medications and/or medical procedures

  • blood-thinning medications to prevent clots
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  • heart rate control medications that bring the heart rate to a normal level
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  • heart rhythm control medications that restore or maintain normal heart rhythm
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  • electrical cardioversion –paddles are applied to the chest to shock the heart back into a normal rhythm
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  • catheter ablation – wires are inserted into veins in the leg or arm and threaded to the heart to alter abnormal areas that may be causing the abnormal heart rhythm
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  • surgical maze – small cuts are made in the heart, creating a “maze” that prevents the abnormal beats from controlling the heart. This is a very effective treatment, but because this requires open heart surgery, it is often used when other options have failed.
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  • It’s not a one-time episode!

    Afib is often an ongoing condition that needs to be managed. Women say having regular appointments with their cardiologists and taking medicines to steady their hearts is something you need to follow to maintain a healthy life.

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Can Surgery Be Used to Treat Heart Failure

In heart failure, surgery may sometimes prevent further damage to the heart and improve the heart’s function. Procedures used include:

Coronary artery bypass grafting surgery. The most common surgery for heart failure caused by coronary artery disease is bypass surgery. Although surgery is more risky for people with heart failure, new strategies before, during, and after surgery have reduced the risks and improved outcomes.

Heart valve surgery

Diseased heart valves can be treated both surgically (traditional heart valve surgery) and non-surgically (balloon valvuloplasty).

Implantable left ventricular assist device (LVAD). The LVAD is known as the “bridge to transplantation” for patients who haven’t responded to other treatments and are hospitalized with severe systolic heart failure. This device helps your heart pump blood throughout your body. It allows you to be mobile, sometimes returning home to await a heart transplant. It may also be used as destination therapy for long-term support in patients who are not eligible for transplant.

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Heart transplant

A heart transplant is considered when heart failure is so severe that it does not respond to all other therapies, but the person’s health is otherwise good.

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What Medications Should I Avoid if I Have Heart Failure

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How Can I Improve My Quality of Life With Heart Failure

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How Can I Prevent Heart Failure From Worsening?

Keep your blood pressure low

In heart failure, the release of hormones causes the blood vessels to constrict or tighten. The heart must work hard to pump blood through the constricted vessels. It is important to keep your blood pressure controlled so that your heart can pump more effectively without extra stress.

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Monitor your own symptoms

Check for changes in your fluid status by weighing yourself daily and checking for swelling. Call your doctor if you have unexplained weight gain (3 pounds in one day or 5 pounds in one week) or if you have increased swelling.

Maintain fluid balance

Your doctor may ask you to keep a record of the amount of fluids you drink or eat and how often you go to the bathroom. Remember, the more fluid you carry in your blood vessels, the harder your heart must work to pump excess fluid through your body. Limiting your fluid intake to less than 2 liters per day will help decrease the workload of your heart and prevent symptoms from recurring.

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Limit how much salt (sodium) you eat

If you follow a low-sodium diet, you should have less fluid retention, less swelling, and breathe easier.

Monitor your weight and lose weight if needed

Learn what your “dry” or “ideal” weight is. Dry weight is your weight without extra water (fluid). Your goal is to keep your weight within 4 pounds of your dry weight. Weigh yourself at the same time each day, preferably in the morning, in similar clothing, after urinating but before eating, and on the same scale.

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Monitor your symptoms

Call your doctor if new symptoms occur or if your symptoms worsen. Do not wait for your symptoms to become so severe that you need to seek emergency treatment.

Take your medications as prescribed

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Schedule regular doctor appointments

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Stages of Heart Failure

The table below outlines a basic plan of care that may or may not apply to you, based on the cause of your heart failure and your special needs. Ask your doctor to explain therapies that are listed if you do not understand why you are or are not receiving them.

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Stage A

Definition of Stage

People at high risk of developing heart failure (pre-heart failure), including people with:

  • High blood pressure
  • Diabetes
  • Coronary artery disease
  • Metabolic syndrome
  • History of cardiotoxic drug therapy
  • History of alcohol abuse
  • History of rheumatic fever
  • Family history of cardiomyopathy
Usual Treatments
  • Exercise regularly.
  • Quit smoking.
  • Treat high blood pressure.
  • Treat lipid disorders.
  • Discontinue alcohol or illegal drug use.
  • An angiotensin converting enzyme inhibitor (ACE inhibitor) or an angiotensin II receptor blocker (ARB) is prescribed if you have coronary artery disease, diabetes, high blood pressure, or other vascular or cardiac conditions.
  • Beta blockers may be prescribed if you have high blood pressure or if you’ve had a previous heart attack.
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Stage B

Definition of Stage

People diagnosed with systolic left ventricular dysfunction but who have never had symptoms of heart failure (pre-heart failure), including people with:

  • Prior heart attack
  • Valve disease
  • Cardiomyopathy
  • The diagnosis is usually made when an ejection fraction of less than 40% is found during an echocardiogram test.
Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) or angiotensin II receptor blocker (ARB)
  • Beta-blockers should be prescribed for patients after a heart attack
  • Surgery options for coronary artery repair and valve repair or replacement (as appropriate) should be discussed
  • If appropriate, surgery options should be discussed for patients who have had a heart attack.
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Stage C

Definition of Stage

Patients with known systolic heart failure and current or prior symptoms. Most common symptoms include:

  • Shortness of breath
  • Fatigue
  • Reduced ability to exercise
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Usual Treatments
  • Treatment methods above for Stage A apply
  • All patients should take an angiotensin converting enzyme inhibitor (ACE inhibitors) and beta-blockers
  • African-American patients may be prescribed a hydralazine/nitrate combination if symptoms persist
  • Diuretics (water pills) and digoxin may be prescribed if symptoms persist
  • An aldosterone inhibitor may be prescribed when symptoms remain severe with other therapies
  • Restrict dietary sodium (salt)
  • Monitor weight
  • Restrict fluids (as appropriate)
  • Drugs that worsen the condition should be discontinued
  • As appropriate, cardiac resynchronization therapy (biventricular pacemaker) may be recommended
  • An implantable cardiac defibrillator (ICD) may be recommended

Stage D

Definition of Stage

Patients with systolic heart failure and presence of advanced symptoms after receiving optimum medical care.

Usual Treatments

Treatment methods for Stages A, B & C apply
Patient should be evaluated to determine if the following treatments are available options: heart transplant, ventricular assist devices, surgery options, research therapies, continuous infusion of intravenous inotropic drugs and end-of-life (palliative or hospice) care.

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How Is Heart Failure Diagnosed?

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.

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What Are the Types of Heart Failure?

Systolic dysfunction (or systolic heart failure) occurs when the heart muscle doesn’t contract with enough force, so there is less oxygen-rich blood that is pumped throughout the body.

Diastolic dysfunction (or diastolic heart failure) occurs when the heart contracts normally, but the ventricles do not relax properly or are stiff, and less blood enters the heart during normal filling.

A calculation done during an echocardiogram, called the ejection fraction (EF), is used to measure how well your heart pumps with each beat to help determine if systolic or diastolic dysfunction is present. Your doctor can discuss which condition you have.

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Diastole (relaxation)

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Enlarged Liver

If your doctor tells you that you’ve got an enlarged liver, it means it’s swollen beyond its normal size.

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Symptoms

Most of the time, if you have a slightly enlarged liver, you won’t notice any symptoms. If it’s severely swollen, though, you may have:

  • A feeling of fullness
  • Discomfort in your belly

Depending on the cause of your enlarged liver, you may notice symptoms like:

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