Know your risk for heart disease

Cardiovascular disease affects 10 per cent of women between 45 and 64. Here's how to manage your risk.

Tests: How reliable are they – for women?
One area in which gender enters the heart disease equation is the treadmill stress test. This test helps doctors determine the presence of heart disease, but it was designed for men. During a treadmill stress test, patients are outfitted with electrocardiographic leads that record their heart rate. They walk on a treadmill or use a stationary bike, with increasing intensity, until they develop symptoms such as shortness of breath and fatigue. Some women aren't able to achieve the high heart rate needed for diagnosis, which results in treadmill tests being inaccurate for them, says Dr. Marg Blackwell, a clinical instructor of medicine and rural family practice at the University of British Columbia in Vancouver.

Other standard tests given to heart attack patients include:
• Electrocardiogram (ECG). According to Dr. Rob Myers, the author of Heart Disease (Key Porter, 2004), an ECG is a rapid and noninvasive test that provides accurate diagnostic information from a long list of cardiac problems, such as heart rhythm.

• Perfusion imaging. Prior to treadmill testing, your doctor inserts an intravenous line through which the drug thallium or hexamibi is injected and absorbed by the heart. A special machine takes pictures of the heart, which indicate in what part of the heart the drug has settled. If you have suffered a heart attack, part of your heart muscle is dead and no longer receives blood, so it also won't absorb the drug.

• Echocardiography. Also known as cardiac ultrasound, or echo, these tests are painless and safe. They provide detailed information about cardiac anatomy and function, such as weakness of the heart muscle and heart-valve abnormalities.

• Magnetic resonance imaging (MRI). Cardiac MRI provides more detailed images than echocardiography.

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