DEAR DR. DONOHUE: Both my wife and I have angina. We see different doctors and take different medicines. Her doctor says heart disease in women is different from heart disease in men. I can't swallow that. A heart is a heart. I'd like to hear what you think about this. -- K.O.
A: Heart disease in women does differ from heart disease in men. Few experts dispute that. For one, women develop heart disease about 10 years later than men. That's one point in their favor. However, they suffer more serious consequences of heart disease than do men and are more likely to die of a heart attack than are men. They have different risks for developing heart disease. They often have different manifestations of heart disease.
Female heart arteries are smaller than male heart arteries, so female arteries plug up with plaque more quickly than do male arteries. Furthermore, female heart disease often takes place in the heart's smallest arteries -- arteries so small that they can't be seen when dye is injected into heart arteries. That makes angiograms -- the injection of dye into heart arteries -- less diagnostic for women.
Stress tests for heart disease are less accurate in women. The reasons for that aren't completely understood/known, but it's another example of the difference between the two sexes.
For readers, the angina that K.O. speaks of is chest pain that comes on with activity and goes when the activity is stopped. It is one of the foremost symptoms of plugged heart arteries.
DEAR DR. DONOHUE: Even in warm weather, when I go shopping and reach in for frozen food or take food out of the freezer in my refrigerator, my fingertips get very cold, turn white and have a stinging sensation. Sometimes my feet do the same. What is my problem? What can I do to help myself? All I know is that it's bad circulation. -- B.F.
A: The problem is Raynaud's phenomenon. If you count blood vessels as part of the circulation, it's not bad circulation. It's too-good circulation. Everyone's arteries, when exposed to cold, clamp down to conserve body heat. Your arteries have an exaggerated response to cold exposure. They clamp down so tightly that no blood gets to your fingers (and toes). That accounts for the color change and the sensations. Emotional situations can provoke the same response. When you go food shopping, take gloves -- mittens are even better -- with you and put them on before reaching for frozen foods. Do the same when you reach into your refrigerator's freezer. Don't smoke. Give up caffeinated beverages. When you must leave a very hot environment and enter a highly air-conditioned building, don't do so suddenly. Linger in the doorway or lobby for a while. You can end an attack by putting your hands under hot water or by putting them under your arms. Twirling your arms in a windmill fashion can force blood back into the fingers. Medicines like nifedipine, diltiazem and nitroglycerin can control Raynaud's symptoms if you're not able to control them on your own. In a few instances, Raynaud's is a sign of an underlying illness such as rheumatoid arthritis, lupus or scleroderma. You should tell your doctor your symptoms so a few tests can be done to check on these illnesses.
The booklet on coronary (heart) artery disease explains this No. 1 killer and its treatment in great detail. Readers can obtain a copy by writing: Dr. Donohue -- No 101, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 with the recipient's printed name and address. Please allow four weeks for delivery.
DEAR DR. DONOHUE: My husband was born in January of 1929. His mother died in April of 1929 from tuberculosis. His father died of TB in 1931. How come he never contracted the disease? -- A.S.
A: Not everyone who breathes in the TB germ comes down with tuberculosis. Most wall off the germ in a calcium coffin. Your husband was one of those people.
He was also very lucky.
