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More women suffering from heart disease

New service on trial next year at National University Hospital's heart centre.
December 11, 2012
By: Poon Chian Hui
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More women suffering from heart disease

MORE women are being stricken with heart problems, and their condition is often starkly different from men, according to medical centres.

Not only are they much older when the disease strikes, but many display vague symptoms, like breathlessness.

In view of the disparities, the National University Hospital's heart centre will put a new service on trial next year. It will station heart doctors at its obstetrics and gynaecology clinic.

This is partly because hormones seem to play a part in heart disease, said Associate Professor Carolyn Lam of the National University Heart Centre Singapore.

Heart disease usually hits women around the age of 65, and about 55 for men. It has been postulated that the female hormone oestrogen protects against heart disease because problems seem to surface after menopause.

"I truly believe a woman-centric approach in heart disease will help," said Prof Lam, who added that women also tend to feel more comfortable with their gynaecologists.

The National Heart Centre Singapore (NHCS) saw a 10 per cent rise in new female outpatients from 2007 to hit 8,300 last year.

At Tan Tock Seng Hospital (TTSH), the number of female subsidised patients with the disease is projected to rise 16.5 per cent this year from 2010. It expects 17,025 visits from women with the disease this year, both old and new cases.

For men, the increase is projected to be around 14 per cent.

Dr Aaron Wong, head of the NHCS interventional cardiology unit, said the 10-year lag means women are more likely to have other illnesses, like diabetes, by the time they get heart problems.

"The risk of complications, such as excessive bleeding, is also higher," he said.

Prof Lam said that many display atypical symptoms such as breathlessness and back pain, instead of the "classic Hollywood movie" sign of chest pain.

TTSH consultant cardiologist Irene Chung said the vague signs and the older age of female patients are a challenge.

"The more elderly they are, the more likely that they are not as educated," she said. "It can be difficult for them to describe (their problem) to health-care workers."

Prof Lam said that even these tell-tale signs tend to get mixed up with menopausal symptoms.

Doctors said all this can delay diagnosis and affect survival.

Although women with cardiovascular disease made up fewer than half of such patients at medical centres, official figures showed that heart-related diseases were responsible for about 30 per cent of all deaths of women last year - the same for men.

A study here of more than 15,000 patients published this year showed that in cases of acute coronary syndrome, women were twice as likely to die as men.

Doctors suggest that this may boil down to physical make-up. Women have smaller arteries than men, even after adjusting for body size, said Dr Chung.

Dr Wong said women are slightly more prone to dysfunctions that can send blood vessels into spasms.

"The artery closes off, and it becomes difficult to do things like insert wires during procedures to clear blocked vessels."

chpoon@sph.com.sg

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