What to do if you have symptoms
When carrying groceries up one flight of stairs prompts out-of-the-ordinary breathlessness or a burning pain anywhere, front or back, between your belly button and chin, you may be noticing signs of heart disease. Other symptoms include unusual fatigue, dizziness, nausea, or a tightness in the chest. For women, cardiologists are turning to a new generation of diagnostic techniques. You should always start with either an echocardiogram or nuclear stress test, says Oz.
Echocardiogram: This is basically an ultrasound of the heart, usually conducted by passing a wand across your chest.
Nuclear stress test (also called cardiac or myocardial perfusion imaging or SPECT): With a small amount of an injected radioactive substance, a camera shows if the heart is receiving adequate blood supply when you're both at rest and at peak exercise on a treadmill or bicycle. The beauty of this test is that it can pick up evidence of small vessel disease.
CT angiogram: This test is becoming increasingly useful at the symptom stage as well, says Jennifer Mieres, MD, director of nuclear cardiology at New York University School of Medicine and chair of the American Heart Association's Cardiac Imaging committee. “The CT angiogram is especially good for looking at hidden plaque without calcium,” adds Oz.
Cardiac MRI: Another promising up-and-comer that uses a strong magnetic field and radio waves to create images of your heart. It's mostly available at big academic centers and may prove especially helpful in younger, perimenopausal women, says Mieres. “Ultimately, these tests are not going to save your life,” says Mosca. “You are going to save your life, because you are going to be committed to a heart-healthy lifestyle.” While a recent national survey pointed out that a mere 3 percent of American adults fully follow heart-healthy habits, we all know the drill. Give up smoking. Choose foods wisely. Stay at a healthy weight. And be active for at least 30 minutes on most days. Says Mieres: “Small steps make a difference.”
If persistent symptoms go undiagnosed, don't give up. “Everybody's looking for the magic test, and we don't have that,” says Nieca Goldberg, MD, chief of women's cardiac care at New York's Lenox Hill Hospital. “Find a doctor who's listening.”
Alison Motluk is the Toronto correspondent for The New Scientist magazine.