Healthy from the Heart

1. Healthy from the Heart What I Need to Know about Coronary Artery Disease

2. Welcome to Healthy from the Heart • Healthy from the Heart – An educational program designed to encourage women like you to learn about coronary artery disease treatment options. • Coronary artery disease is the most common type of heart disease - 13 million Americans diagnosed. • But today’s treatments offer better results and quality of life than ever before.

3. What You’ll Learn Today • Facts about women and heart disease • What women know…and don’t know… about treatments for heart disease • How your heart works • What coronary artery disease is…and its causes, risk factors and symptoms • How coronary artery disease is diagnosed and treated

4. Women & Heart Disease: The Facts

5. Women & Heart Disease • “Heart disease has not yet risen to the prominence it deserves as an issue in women’s health.” • “In the United States and many developed countries, coronary heart disease is the most common cause of death among women.” • “Yet heart disease often is unrecognized among women, in part because women are more likely than men to have atypical chest pain, abdominal pain, dyspnea, nausea, or unexplained fatigue as symptoms of coronary heart disease.” “Women’s Health – Advances in Knowledge.” JAMA, March 22/29, 2006—Vol. 295, No. 12

6. Women & Heart Disease • More than 500,000 women die of cardiovascular diseases annually, including diseases of the heart and blood vessels, and stroke. (AHA) • More women have died of cardiovascular diseases than men since 1984. • Almost half of women diagnosed with coronary artery disease were unaware that they were at risk until they were diagnosed. (2003 survey by Mayo Clinic, Rochester, Minn.) • Women were not as likely as men to be referred for cardiac catheterization, a procedure to unclog arteries. (Major study published in New England Journal of Medicine in 1999)

7. Minority Women & Heart Disease • 32.6% of deaths among Hispanic females can be attributed to heart disease and stroke. (AHA) • African-Americans are 29% more likely to die from heart disease than Caucasians. (HHS) • 26.7% of African-Americans have hypertension compared to 20.1% of Caucasians. (AHA)

8. Minority Women & Heart Disease • 70% of Latina/Hispanic women say that their doctor never discussed that they are in a high-risk group for heart disease. (Circulation, Feb. 10, 2005) • Just 12% of African-American women and 22% of Hispanic women know that a family history of heart disease increases a woman’s risk for heart disease, compared to 35% of white women. (Circulation, Feb. 10, 2005)

9. Healthy from the Heart Survey: Tracked National Awareness about Heart Disease Treatments among Women

10. Healthy from the Heart Survey • Public information and media coverage tend to emphasize prevention. • But…topic of treatment options for those diagnosed with heart disease underserved. • In April 2006, Cordis Corporation’s Healthy from the Heart campaign conducted a nationwide survey among nearly 2,000 women, ages 35+, to identify current awareness levels about available heart disease treatment options.

11. Survey Results: Worry about Heart Disease Ranks High Women over age 35 are more concerned about heart disease than breast cancer and osteoporosis. • 26% over age 35 are concerned about heart disease, compared to 21% women concerned about breast cancer and 18% women concerned about osteoporosis. • Significantly more African-American women over age 35 (37%) are concerned about heart disease than their Caucasian (22%) and Hispanic (21%) counterparts. • Hispanic women are slightly more concerned about breast cancer (23%) than heart disease. Only 21% are concerned about heart disease. • About 1/2 of women (48%) surveyed have a family history of heart disease but only 12% have been diagnosed.

12. Survey Results: Broad-based Lack of Awareness about Treatment • Women often unaware and ill-informed of what to do after they or a loved one has been diagnosed with heart disease. • Nearly three-quarters of women over age 35 (73%) feel they know how to prevent heart disease. • BUT…only slightly more than half (55%) feel they know how to treat the condition.

13. Survey Results: Confusion over Prevention vs. Treatment • Women over age 35… • Are confusing heart disease prevention techniques with treatment options – with few knowing how to treat the disease. • Most often mentioned prevention techniques such as medications (51%), exercise (30%) and eating healthy (26%) as treatments for heart disease. 

14. Survey Results: Little Knowledge of Specific Treatments • Women over age 35 are largely unaware of interventional treatment options – with few mentioning them unprompted: • Surgery (27%) • Angioplasty (7%) • Stent placement (5%)

15. Survey Results: Less Knowledge among Hispanic & African-American Women • Hispanic and African-American women over age 35 are less aware of heart disease treatment than Caucasian women • Hispanic (23%) and African-American (29%) women over the age of 35 were more likely to respond than Caucasian women (13%) that they did not know any treatments for heart disease • Interventional treatment options are more known by Caucasians (33%) than African-Americans (17%) and Hispanics (3%) • African-American women were least aware of the symptoms of heart disease, with 21% responding that they did not know ANY symptoms

16. What Is Coronary Artery Disease? • Causes • Risk Factors • Symptoms

17. The Human Heart: How It Works • Right Atrium receives venous blood from body. • Left Atrium receives oxygenated blood from lungs. • Right Ventricle pumps venous blood to lungs for oxygen. • Left Ventricle pumps blood out to body through arteries. Left Atrium Right Atrium Left Ventricle Right Ventricle

18. The Human Heart: How It Works • The heart is a muscular organ. To function properly, the heart must receive oxygen. • Oxygen is supplied to the heart by the coronary (heart) arteries that wrap around the surface of the heart.

19. Coronary Artery Disease: What It Is • Many things can cause one or more of these arteries to become narrowed or blocked with deposits known as plaque. • Fatty substances, such as cholesterol, and other blood components can build up on artery walls over time, making the arteries more narrow, “hard” and less flexible.

20. Coronary Artery Disease: What It Is • Narrowing of artery will restrict blood flow and your heart will not receive enough oxygen to work properly. • Chest pain, called angina, may occur. • If the artery becomes severely blocked, a heart attack can occur.

21. Risk Factors for Coronary Artery Disease • Although the exact cause of hardening of the arteries is not known, risk factors include: • High blood pressure • Having a close family relative with heart disease • High cholesterol • Diabetes • Smoking • Excessive weight • Lack of regular exercise

22. Symptoms of Coronary Artery Disease • Symptoms of coronary artery disease can range from mild to severe. They include: • Fatigue • Shortness of breath • Chest pain that often can be felt in the jaw, arm or back • Uneven or rapid heartbeats (palpitations) • Dizziness

23. How Is Heart Disease Diagnosed?

24. Diagnostic Tests • If you have experienced symptoms or have an increased risk of heart disease, you may have had: • Exercise stress test • Electrocardiogram (EKG) • Chest X-ray • Blood tests • Cardiac catheterization or coronary angiogram

25. Coronary Angiogram • One of the most useful methods for diagnosing coronary artery disease is called a coronary angiogram. • A colored dye is injected into the coronary arteries using a tube called a catheter. • This allows the physician to see, on an X-ray screen, exactly where the artery is narrowed or blocked.

26. Coronary Angiogram • In coronary angioplasty, a catheter is inserted into an artery and then guided to your heart.

27. How Is Heart Disease Treated? Balloon Angioplasty Coronary Stents Open Heart Surgery

28. Advanced Treatments • While coronary artery disease is a serious condition, current treatment using advanced techniques makes it possible for women with the condition to live active, healthy lifestyles.

29. Balloon Angioplasty • Angioplasty widens narrowed arteries by threading a balloon-tipped catheter through the arm or groin artery to the blocked artery in the heart. • The balloon is inflated to compress the plaque against the artery walls, which in turn expands the blood vessel so blood can flow through more easily. • The balloon is then deflated and the catheter is removed, but the artery remains blockage-free.

30. Balloon Angioplasty • Balloon angioplasty: inflated balloon in partially blocked artery.

31. Balloon Angioplasty with Coronary Stent • The most common procedure for treating coronary artery disease is a balloon angioplasty with a coronary stent. • The procedure involves the insertion of a stent, a wire spring-like mesh tube or “scaffold,” into the artery to keep it open after the angioplasty.

32. How Is a Coronary Stent Implanted?

33. Advanced Treatment: Drug-eluting Stents • Even after treatment, it is possible for arteries to re-narrow or become blocked at the site where treatment took place due to a type of scar-tissue formation. This is called restenosis. • To lower the risk for restenosis, your doctor may recommend an advanced treatment called drug-eluting stents.

34. Advanced Treatment: Drug-eluting Stents • Drug-eluting stents help open the artery and release small amounts of a medication inside the artery over a period of time. • This helps to keep plaque from reforming and prevent repeat blockage from occurring inside the blood vessel.

35. Advanced Treatment: Drug-eluting Stents • Today, nearly 90% of coronary stent procedures involve the use of drug-eluting stents. • The use of drug-eluting stents combined with angioplasty makes non-surgical therapy a treatment option for many more patients than ever before.

36. Open Heart Surgery • Coronary artery bypass surgery is a safe and effective treatment option for some patients with coronary artery disease who may not qualify for angioplasty and stent insertion. Your doctor will determine the best option for you. • The operation uses blood vessels, typically taken from the leg or chest, to go around or “bypass” clogged coronary arteries so blood can flow through the new vessels to the heart muscle. • Many coronary bypass operations are performed with the patient breathing with a pump oxygenator or heart-lung machine.

37. Questions for Discussion with Your Healthcare Team • What type of heart disease do I have? • What are the best treatment options for me? • What are the differences between bypass surgery and angioplasty with drug-eluting stents? Which technique makes more sense for my condition? • Are there any differences among drug-eluting stents? • What are the risk and benefits of my treatment options? • What lifestyle changes should I make to better protect my heart health?

38. Take Charge! • Coronary artery disease can be safely and effectively treated. • Now that you’ve learned about the disease and treatment options, you can have an informed discussion with your physician about what’s best for you.

39. Healthy from the Heart Thank you!