It’s a trend Henry Ford Health cardiologist Dr. Sindhu Koshy has noticed in her Sterling Heights practice.
“I’ve been seeing more and more women between the ages of 40 and 65 having their first cardiac events, whether that’s AFib or heart attack, heart failure,” said Koshy.
But that trend didn’t match her training.
“I was taught back in school that that only happens to women when they’re over the age of 65,” explained Koshy. “We’re basically taught women under that age coming in with heart-like symptoms are low risk, and so probably not their heart, it’s probably something else.”
Jennifer Williams is a prime example of why that can be a dangerous misconception. The 53-year-old was at home in Clinton Township with her husband, getting ready for work, when she developed concerning symptoms.
“The moment I sat down, I felt a huge weight on my chest,” said Williams. “Both arms went numb. I had numbness and a pulling sensation in my chin area, and I felt the need to go to the restroom.”
Williams had previously suffered from panic attacks, but this felt different. She asked her husband to call an ambulance.
“He was going to offer to drive, but could not finish his sentence, and I told him, ‘Call 911,’” said Williams.
At the hospital, Dr. Koshy determined that Williams was having a heart attack.
“She was a young woman who came in with heart symptoms. A lot of people thought it was anxiety, but she was having a massive heart attack of her widowmaker,” said Koshy.
As Koshy investigated the trend she was seeing, she realized perimenopause and menopause were often the tipping point in her female patients’ heart health.
“The lower your hormones drop, your cholesterol goes up, your blood pressure goes up. You can become a prediabetic or a diabetic,” said Koshy. “Add that with your family history, and suddenly you’re at risk for heart disease, which you didn’t know 10 years prior, because as a young woman, you didn’t have those issues.”
It’s become a passion of hers to better guide women through this portion of their lives.
“I wanted to make sure that women understood that their risk was increasing, as a preventative cardiologist, and so I also became menopause-certified, so that I can talk to women and other providers about hormone supplementation along with cardiac disease and what that can mean,” said Koshy.
One key message is that certain menopause symptoms can also signal a higher risk of heart issues.
“We have found out that vasomotor symptoms, which are hot flashes or night sweats, which many women experience during perimenopause and menopause, the more you have them, even per week, actually shows us that that’s an increased risk for cardiac disease for a lot of reasons,” said Koshy. “One, this is a vascular issue, and so that means that your blood vessels aren’t doing what they’re supposed to. So the more you have of these, we need to treat them. Also, you’re not sleeping. If you’re not sleeping, that’s a high risk for heart disease, that raises your blood pressure. So we definitely want women who are suffering from those things and the symptoms that we relate with menopause to be treated because it helps our heart also.”
Williams needed an immediate procedure to open her blocked artery. She now has two stents.
“What I’ve learned, No. 1 is listen to yourself. That little voice that you hear is there for a reason. So I always listen to myself, and I listen my body,” said Williams. “The other thing is, don’t be afraid to ask for help. There’s a lot of people out there who are willing to help.”
“This is just a shift in our body. We cannot prevent menopause from happening. It’s going to happen, but now we know how to deal with it and mitigate some of that risk,” said Koshy.
Koshy recommends visiting The Menopause Society website to find a provider who is menopause-certified, which means they’ve had specific additional training in the effects of perimenopause and menopause.
That provider can help sort out the best approach for managing the symptoms and changing risks that women face during this time.