Cardiac catheterization in women

Seven's On Call with Dr. Jay Adlersberg
July 1, 2008 4:28:06 PM PDT
There is new information about finding blockages in women's hearts, and why it may not be good for everyone.With cardiac catheterization, doctors can go inside the heart arteries and open up blockages or put in stents. Now, a report in the Journal of the American Medical Association says this method works for some women, but may not be the best for others.

When Virginia Devlin started feeling tightness in her chest and tingling in her arm, she thought about a heart attack. She had a strong family history of heart attacks.

"I'm one of five children," she said. "All five children have had heart attacks or heart symptoms."

So Virginia's doctors ordered a cardiac catheterization. The pictures of her arteries showed she had a partial blockage in one artery, so they placed a stent.

New research shows the procedure benefits high-risk women, but may not be the best for others.

"Low-risk women do not appear to have a substantial benefit from a routine invasive strategy, and this strategy may even potentially be harmful," said Dr. Michelle O'Donoghue, a cardiologist at Brigham and Women's Hospital.

O'Donoghue compared treatment strategies in about 10,000 men and women with unstable heart disease.

They found that women who had suffered a heart attack appeared to benefit just as much as men following routine cardiac catheterization. But women who experienced a near heart attack, also called unstable angina, had an increased risk of experiencing a heart attack or death after the procedure.

"A more conservative strategy would be primarily managing these patients with medicines and then reserving cardiac catheterization only for those patients who either have ongoing symptoms or have a positive stress test before leaving the hospital," Dr. O'Donoghue said. "Women appear to have a higher incidence of diabetes, high blood pressure and high cholesterol when they come into the emergency room, and that may put them at higher risk of complications after cardiac catheterization."

Virginia is doing what she can to stay healthy.

"I'm exercising more, and I'm eating better than I was," she said. "So all of those are on the plus side."

The findings are in line with what the American Heart Association and the American College of Cardiology recommend. Low-risk women would need further testing, so women should do their best to understand all the factors that put them at at either low or high risk.


STORY BY: Dr. Jay Adlersberg