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STEPHEN G. SWANSON, MD, FACOG
“NEW UNDERSTANDING”
RECOGNITION, PREVENTION,
DIAGNOSIS, AND TREATMENT
WOMEN AND HEART DISEASE
#1 Cause of Death in Women Over 40
22. 9 percent of All Deaths in Women
Only 1 in 5 Women Believe Heart
Disease is
THEIR GREATEST RISK
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1. OBS TETRICAL C OMPL ICATIONS
A. GESTATIONAL HYPERTENSION
B. PRE-EC L AMPSIA
C. GESTATIONAL DIABETES
D. PRE-TERM LABOR
E. PERS IS TENT “BABY WEIGHT” POS T 3-12 MONTHS
Risk Factors Specific to Women
2 . I N F E R T I L I T Y - A N O V U L A T I O N - I R R E G U L A R P E R I O D S
A . P O L Y C Y S T I C O V A R Y S Y N D R O M E
B . O B E S I T Y — E L E V A T E D S E R U M I N S U L I N L E V E L S
C . M E T A B O L I C S Y N D R O M E
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3. V ALVUL AR HEART DISEASE—
DISC OVERED IN PREGNANCY
4. BREAST C ANC ER
A. CHEST RADIATION
B. CHEMOTHERAPY
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UNIQUE WOMEN’S CARDIAC PROBLEMS
SPONTANEOUS CORONARY ARTERY DISSECTION
(SCAD)
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TAKOTS U BO—
STRESS INDUCED CARDIOMYOPATHY
(CM)
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MICROVASCULAR DISEASE
(MVD)
HEART FAILURE WITH PRESERVED EJECTION
FRACTION
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PERIPARTUMCARDIOMYOPATHY
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VALVULAR HEART DISEASE
AND PREGNANCY
ACUTE CORONARY SYNDROME
MINOCA
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DIAGNOSTIC STUDIES AVAILABLE
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MenopauseHormone Replacement
Heart Disease
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Why Consider HormoneReplacement Therapy?
North American Menopause Society—NAMS
25 Years of Excellent Research
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OR DOES IT?
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Conclusion:
1. Hormone Replacement Therapy Improves Quality of Life Issues.2. Most Benefits Up to Age 60
? May be Up to Age 703. Significant Improvement in Osteoporosis4. Assists in Management of Weight gainWith Visceral Weight5. Improves Postmenopausal ↑ in LDL and
Lipoproteins6. No Significant Increases in Incidence of Breast Cancer. NOT CAUSATIVE.7. Replace Estrogen Transdermal and Does Not
↑ Most Clotting Problems
Risks and Benefits Should Be Carefully Evaluated for Each Patient and Based Upon Their Entire Medical Condition