Assessment Of Skeletal Muscle Fatigue In Men With Coronary Artery Disease Using Surface Electromyography During Isometric Contraction Of Quadriceps Muscles
- Laboratoire de Recherche, Faculté des Sciences du Sport, Université de Picardie Jules Verne, Amiens FranceCentre de Réadaptation Cardiaque, Hôpital de Corbie, Corbie, France.
- Said AhmaidiCorrespondenceReprint requests to Said Ahmaidi, PhD, Laboratoire EA 3300, APS et Conduites Motrices: Adaptations-Réadaptation, Faculté des Sciences du Sport, Allée P. Grousset, 80025, Amiens, France.
How Is Coronary Artery Disease Diagnosed
In addition to a complete medical history and physical exam, tests for coronary artery disease may include the following:
Electrocardiogram . This test records the electrical activity of the heart, shows abnormal rhythms , and detects heart muscle damage.
Stress test . This test is given while you walk on a treadmill to monitor the heart during exercise. Breathing and blood pressure rates are also monitored. A stress test may be used to detect coronary artery disease, or to determine safe levels of exercise after a heart attack or heart surgery. This can also be done while resting using special medicines that can synthetically place stress on the heart.
Cardiac catheterization. With this procedure, a wire is passed into the coronary arteries of the heart and X-rays are taken after a contrast agent is injected into an artery. It’s done to locate the narrowing, blockages, and other problems.
Nuclear scanning. Radioactive material is injected into a vein and then is observed using a camera as it is taken up by the heart muscle. This indicates the healthy and damaged areas of the heart.
Improving Health With Current Research
Learn about the following ways the NHLBI continues to translate current research into improved health for people with heart disease. Research on this topic is part of the NHLBI’s broader commitment to advancing heart and vascular disease, population and epidemiology studies, and womens health scientific discovery.
Learn about some of the pioneering research contributions we have made over the years that have improved clinical care.
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Can Symptoms Differ For Women
Although men and women can experience the same symptoms of coronary heart disease, women often experience no symptoms or have different symptoms than men do.
- Activity that brings on chest pain. In men, angina tends to worsen with physical activity and go away with rest. Women are more likely than men to have angina while they are resting. In women who have coronary microvascular disease, angina often happens during routine daily activities, such as shopping or cooking, rather than during exercise. Microvascular angina events may last longer and be more painful than other types of angina.
- Location and type of pain. Pain symptoms are different for each person. Women having angina or a heart attack often describe their chest pain as crushing, or they say it feels like pressure, squeezing, or tightness. Women may have pain in the chest or the neck and throat.
- Mental stress. Mental stress is more likely to trigger angina pain in women than in men.
- Other symptoms. Common signs and symptoms for womenincludenausea, vomiting, shortness of breath, abdominal pain, sleep problems, Fatigue, and lack of energy.
How Does Smoking Affect Coronary Heart Disease
Smoking, whether your own or secondhand, raises your risk of getting CAD. Thatâs because chemicals in cigarette smoke can inflame the cells that line your blood vessels. This can make them narrower. It also may thicken blood so that it clots more easily.
Talk to your doctor about getting help to quit smoking.
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What Causes Coronary Artery Disease
Coronary artery disease occurs when cholesterol-containing deposits builds up in the coronary arteries, decreasing blood flow to your heart. It can also be caused by things that cannot be avoided, like menopause, aging or having a family with a history of heart disease.
There are things you can do to reduce your risk of having a heart attack, like quitting smoking, taking steps to lower cholesterol, exercising regularly, keeping diabetes and high blood pressure under control and seeing your doctor regularly.
Coronary Artery Disease In Women
Although Coronary Artery Disease is often thought of as a problem for men, more women than men die of heart disease each year. Women are six times as likely to die of heart disease as of breast cancer. Heart disease kills more women over 65 than do all cancers combined.
The most common symptom in both women and men is chest pain. But for women this may not be the most prominent symptom. Chest pain may feel like a burning, tightness, pressure or some other sensation. A better word than pain might be discomfort. This discomfort may radiate, or seem to originate, in the jaw, back, mid-stomach or either arm.
One of the distinguishing factors between women and men is that women tend to report more associated symptoms. These may include classic symptoms such as shortness of breath, nausea and vomiting but may also include several less classic symptoms including fatigue, dizziness and palpitations.
While it is most common for both genders to get their symptoms with physical exertion, women may also experience their symptoms at rest, during sleep and with emotional stress. Likewise, women may have an increased frequency of symptoms around the time of their menstrual period.
If you are concerned about your heart, you can try this questionnaire for the Prediction of Coronary Artery Disease .
Risk factors and symptoms:
- Neck, shoulder, upper back or abdominal discomfort
- Shortness of breath
- Lightheadedness or dizziness
- Unusual fatigue
In coronary MVD:
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When To See A Healthcare Provider
If you experience intermittent symptoms of CAD, you should tell your healthcare provider. Many people avoid talking about symptoms or ignore them out of fear or denial. Without treatment, CAD will get worse and can suddenly cause a fatal heart attack, or can cause a heart attack that results in lifelong complications and a diminished quality of life.
If you experience angina or symptoms of what seems to be a heart attack, you need to get emergency medical attention.
How Do You Treat Coronary Artery Disease
Your treatment may involve:
Lifestyle changes. If you smoke, quit. Itâs a big risk factor for CAD. Your doctor may also talk to you about your diet — less fat, salt, and sugar, and more vegetables, fruits, lean meats, and whole grains.
- Avoid alcohol, or at least cut back.
- Keep a healthy weight. .
- Manage your stress.
Medications. If lifestyle changes arenât enough, you might need medication. The drugs youâll take depend on your situation. If youâve been diagnosed with coronary artery disease, you could take:
- Stent placement
All of these treatments boost blood supply to your heart, but they canât cure coronary artery disease.
Doctors are also studying new ways to treat heart disease, including:
- Angiogenesis. For this treatment, youâll get stem cells and other genetic material through your vein or directly into your damaged heart tissue. It helps new blood vessels grow and go around the clogged ones.
- Enhanced external counterpulsation . People who have long-term angina but havenât gotten any help from nitrate medications or donât qualify for some procedures may find relief with this. Itâs an outpatient procedure — one where you wonât need to be admitted to the hospital — that uses cuffs on the legs that inflate and deflate to boost blood supply to your coronary arteries.
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Chronically Tired Fatigue May Be A Sign Of Heart Problems
Heart disease is one of the number one killers in the United States. Our womens health care providers are here to help you stay healthy. Thats why were spreading the word about a subtle, but dangerous sign that you could have heart disease: fatigue.
Fatigue can stop you in your tracks and even signal serious problems like heart disease. Feeling abnormally tired? Talk to our womens health care provider.
Many of us mistakenly believe that heart disease is mainly a concern for men. However, women are also at risk for this serious health condition.
Here are some quick facts on heart disease in women:
- Heart disease is responsible for 1 in every 5 female deaths
- 1 in 16 women 20 years old or older have coronary artery disease
Women often experience different symptoms of heart disease than men, which can make it hard to notice early warning signs. If youre experiencing unexplained tiredness and fatigue, come to our womens health clinicto help find the root of the problem.
Can Coronary Artery Disease Be Prevented
You can certainly make changes that will lower your chance of developing coronary artery disease, but this condition is not 100% preventable. This is because there are two kinds of risk factors: Those that cant be changed and those that can be .
Nonmodifiable risk factors include older age, male gender, a family history of heart disease and genetic factors. See the question, who gets coronary artery disease earlier in this article for more information.
However, there are many risk factors that you can modify. These are mostly lifestyle changes like losing weight if youre overweight, stopping smoking if you smoke, keeping your blood pressure and cholesterol level at their goal numbers and managing diabetes. See lifestyle changes under the treatment section of this article for more examples.
Keep in mind that the more risk factors you have, the higher the chance of having heart disease. Fortunately, you can choose to help yourself and reduce the risk of disease by taking control over your risk factors that can be changed.
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Compassionate Understanding Womens Health Care At Herkare
Our team at HerKare is here to help you feel great again. We put you in charge at our womens health clinic. Our goal is to help you stay healthy and help improve your quality of life. Whether you need an annual exam or are coming in to talk about any symptoms or concerns you have about your health, we believe in providing compassionate womens health care in a welcoming environment. We take time to listen and understand, and then help you feel better. Make an appointment today and lets talk about your health and wellbeing!
Alternative Therapies For Refractory Angina
Some patients have CAD with intractable angina despite maximum medical therapy and may not be candidates for revascularization. One option for these patients is spinal cord stimulation, in which an electrode is inserted into the epidural space at the C7-T1 level. This electrode stimulates axons in the spinal cord that do not transmit pain so as to reduce input to the brain of axons that do transmit pain . Spinal cord stimulation has been shown to decrease angina frequency by up to 80%, decrease CCS score, and improve quality of life. One study showed spinal cord stimulation to be noninferior to CABG for quality of life and survival after 5 years of follow-up in patients with refractory angina. Additional trials are needed.
Another technique that has been used for refractory angina is transmyocardial laser revascularization, which creates small channels from the epicardial to endocardial surfaces of the heart with a laser using a surgical approach. The mechanism of action of laser therapy is incompletely understood, and multiple randomized trials have failed to demonstrate an increase in survival. The lack of survival benefit for transmyocardial laser revascularization highlights the important role of the placebo effect in reducing angina with this now rarely used technique.
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How Does Heart Health Affect Fatigue
When you have an unhealthy heart, your whole body is affected. Your heart pumps and funnels blood throughout your body, carrying oxygen and nutrients to every vital organ to function correctly. As a result, when your heart cannot pump and channel blood throughout the body strong and fast enough, the rest of your body has to work extra hard for you to keep functioning. Such is the case with heart failure and fatigue. With heart failure, your heart does not work as efficiently as expected, which decreases the amount of blood it pumps and funnels throughout the body. Your heart chambers respond by stretching to hold more blood, which is a temporary solution to keeping blood moving, but this also weakens your hearts muscles, further weakening its ability to pump blood efficiently. When blood cannot get to your brain, lungs, and muscles fast and strong enough, one of the results is constant and relentless fatigue, often accompanied by weakness, dizziness, and confusion.
Talk To Our Womens Health Care Provider If You Feel Unusually Tired
With the hustle and bustle of everyday life, of course we sometimes feel tired! However, there are some signs that you shouldnt ignore your fatigue. For example, if youre suddenly and overwhelmingly tired without understanding why, this could be something more serious than needing a nap or an extra few hours of sleep.
Some other fatigue symptoms you shouldnt ignore include:
- Youre suddenly exhausted after doing your normal exercise routine
- You feel tired or your chest feels heavy even if youre not exerting yourself
- Simple activities, like making your bed, wear you out
- You feel extremely tired, but are still having a hard time sleeping
These symptoms can signal that something may not be quite right with your health. For example, extreme fatigue can be a symptom of vitamin deficiencies, anemia, and other health conditions. It can also be a sign of heart disease or an impending heart attack.
Unfortunately, many women ignore these signs to seek womens health care. We might chalk them up to aging, a busy schedule, or stress. However, if youre not feeling like yourself, its always better to be safe than sorry and get checked out.
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Understanding Coronary Artery Disease
The leading cause of death in the United States, heart disease affects men and women equally. Every year, heart disease causes almost 650,000 deaths in the US, as well as more than 800,000 heart attacks.
Your coronary arteries carry blood to all parts of the heart muscle. Theyre the major blood pipelines, critical to your heart, and coronary artery disease is the most common disease affecting this crucial organ.
CAD occurs when the coronary arteries become damaged or narrowed, usually due to the accumulation of cholesterol plaques. The result is less blood flow to the heart. CAD can take decades to develop, so you may not have symptoms until you have significant blockage of a coronary artery. Any of the following five warning signs warrants medical evaluation.
Problems Affecting The Blood Vessels
Problems with how the hearts blood vessels work can cause coronary heart disease. For example, the blood vessels may not respond to signals that the heart needs more oxygen-rich blood. Normally, the blood vessels widen to allow more blood flow when a person is physically active or under stress. But if you have coronary heart disease, the size of these blood vessels may not change, or the blood vessels may even narrow.
The cause of these problems is not fully clear. But it may involve:
- Damage or injury to the walls of the arteries or tiny blood vessels from chronic inflammation, high blood pressure, or diabetes.
- Molecular changes that are part of the normal aging process. Molecular changes affect the way genes and proteins are controlled inside cells.
In nonobstructive coronary artery disease, damage to the inner walls of the coronary arteries can cause them to spasm . This is called vasospasm. The spasm causes the arteries to narrow temporarily and blocks blood flow to the heart.
These problems can also happen in the tiny blood vessels in the heart, causing coronary microvascular disease . Coronary microvascular disease can happen with or without obstructive or nonobstructive coronary artery disease.
Learn more about the important role that inflammation, which is the bodys reaction to an injury, plays in the development of coronary heart disease.
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Who Is At Risk For Coronary Artery Disease
Coronary artery disease is the leading cause of death in the United States for both men and women. Each year, more than half a million Americans die from CAD.
Certain traits, conditions, or habits may raise your chance of developing CAD. These conditions are known as risk factors.
You can control most risk factors and help prevent or delay CAD. Other risk factors can’t be controlled.
When To See A Doctor
As mentioned, since symptoms of coronary artery disease are serious, its important that you see a doctor right away. If your symptoms are severe or last longer than 5-minutes it could be a sign of a heart attack that warrants immediate medical attention.
Although rare, if a blood clot in a coronary artery breaks loose, it can move to your brain and cause a stroke, says Cleveland Clinic. Signs of a stroke include arm weakness , slurred speech or difficulty speaking, and drooping on one side of your face. If you develop any of these signs, dial 911 right away. Every minute you spend without treatment increases your risk of long-term damage, says the source.
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Symptoms Unique To Women
Women can experience the same symptoms we just mentioned, however, there are a few symptoms unique to women that are worth mentioning. For starters, women are more likely to also experience nausea and vomiting, as well as back pain, and jaw pain. Shortness of breath without chest pain is also common.
In general, men have a higher risk of developing heart disease than women. That said, once a woman is postmenopausal and age 70, they then have the same risk as men, says Healthline.