The massive influx of women in the workforce of modern nations has produced a widespread phenomenon of “double stress” in their lives as they usually must cope with the work and household requirements at the same time. Even though there has been a shift in the social customs as more men are becoming aware that they must share the household chores, including the rearing of children, there is still an asymmetry in the distribution of tasks. Women still work more. Much more.
Sadly, the recent statistics show that women are catching up with the morbidity and mortality due to cardiovascular diseases due to their newfound responsibilities. In the USA it is the leading cause of death and disability for women of all societal levels. Oftentimes the presentation of cardiovascular disease is atypical in women as they do not show up in the office with the traditional “angor pectoris”; they have persistent anxiety or asthenia or polymorphic pain syndromes in the extremities.
Early in their lives, the estrogens have a protective effect on their cardiovascular system as they promote the formation of HDL-cholesterol, which cleanses the vessels of atherosclerotic plaques. But as menopause approaches, they have less estrogens and the risk of cardiovascular anomalies increases significantly.
As women usually have a richer emotional dimension, there are more instances where they can suffer from an “emotional frustration” and bear consequences. In post-menopausal women an unusually strong emotional event can produce a particular syndrome called “Takotsubo’s cardiomyopathy”. The sudden release of a high amount of adrenalin produces transitory damages to the cardiac muscle with the corresponding clinical presentation mimicking a “heart attack” due to coronary artery disease; the laboratory values and electrocardiogram may be abnormal.
The angiography shows an increase dilatation of the left ventricle, which normally has a triangular shape; it becomes more elongated and rounded, resembling an inverted vase. The Japanese physicians that discovered this clinical syndrome in 1990 named it after the special utensil Japanese fishermen use to catch octopus. Once the acute episode subsides with proper medical therapy, the heart recovers completely and there are no permanent sequelae of a “broken heart” syndrome.
What do you think? Please tell us.
Don’t leave me alone.