Heart disease was once considered a man’s problem, caused by too many martinis and cigarettes and too much boardroom stress. These days, we know better. Heart disease is the leading cause of death for American women, killing nearly 500,000 each year—about twice the number of deaths caused by all types of cancer combined.
Women often experience heart disease differently than men. In the past, this often led to less aggressive medical treatment for women, who sometimes were sent home from the ER during a heart attack because their symptoms differed from those seen in men. In response to these problems, and to accommodate patients who prefer female doctors, Washington University Physicians has gathered an all-women team of board-certified heart experts at Barnes-Jewish Hospital and Barnes-Jewish West County Hospital.
Cardiologist Dr. Kathryn Lindley focuses on cardiovascular complications during and following pregnancy. Lindley completed a yearlong fellowship in that area at Washington University and Emory University in Atlanta. “Women with high-risk heart conditions used to be advised against getting pregnant, but that’s rare these days,” says Lindley, assistant professor of medicine at Washington University. “Given the potential risk of complications, however, women should always get an individual risk assessment and counseling before they conceive, as well as careful management during and after pregnancy.”
Carrying a child puts a huge strain on the heart, Lindley notes. “The heart pumps 50 percent more blood throughout the body, and blood volume increases by 40 percent,” she says. “A normal heart adjusts to these changes, but it’s stressful for women with arrhythmias, cardiomyopathy, high blood pressure, and a history of stroke, heart attack or heart failure. So it’s important they’re cared for by an ob/gyn and a cardiologist experienced in dealing with these issues.” Cardiology team patients have access to the university’s cutting-edge trials and specialists in all fields, including maternal-fetal medicine.
Other issues can develop during pregnancy, even in women with no prior history of heart problems. “Peripartum cardiomyopathy, a type of heart failure that’s probably due to hormonal changes, can develop during the last months of pregnancy or within a month or so after delivery,” Lindley explains. “If not recognized and managed, it can be life-threatening.” Washington University is partnering with other major research institutions to learn more about treating and preventing the condition, she adds.
A recent patient had been told she had hypertrophic cardiomyopathy, a thickening of the heart muscle. “But when she came to us, we discovered it actually was a subaortic membrane, a ridge of tissue right below the aortic valve that narrows the valve and carries a significant risk of heart failure during delivery,” Lindley recalls. “Working with her ob/gyn, we developed a plan that included a C-section and medication to ease fluid retention. Without correct diagnosis and treatment, it could have been disastrous. But we got her through the entire pregnancy with no complications. We love sending moms home safely with healthy babies!”
Pictured: Dr. Kathryn Lindley
Photo by Bill Barrett
[Washington University Physicians’ team of board-certified heart experts includes Drs. Lynne Seacord, Kathryn Lindley and Anita Bhandiwad. For more information, call 314.362.1291 or visit wuphysicians.wu stl.edu.]