Men's Hearts, Women's Hearts:... Video Transcript
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 play videoTime: 08:58 minutes |
Participants
, Marianne Legato MD, Benjamin H. Lewis MD, David R. Marks MD, Mehmet Oz MD, MBA
Summary
The differences between the sexes have been a popular topic for centuries. And so has the idea that the heart is the home of the soul. Modern medicine has discovered some significant dissimilarities between the hearts of men and women. Coincidence? Probably. But the medical facts are interesting -- and important -- nonetheless. Join our panel of experts as they discuss how men's and women's hearts differ, and the medical implications of these findings.
Webcast Transcript
DAVID R. MARKS, MD: Hi, and welcome to our webcast. I'm Dr. David Marks. Well, men and women think differently, and we certainly look different. As it turns out, our hearts are different, too. Here to discuss this, we have three panelists. First is Dr. Marianne Legato. She's professor of clinical medicine and director of the Partnership for Women's Health at Columbia. Welcome. We also have Dr. Benjamin Lewis, assistant professor of clinical medicine, and he's a scholar at the Partnership for Women's Health, also at Columbia. Welcome. And a third from Columbia, Dr. Mehmet Oz. He's a heart surgeon at Columbia Presbyterian Medical Center. Thanks for being here
How are men and women's hearts different?
MARIANNE LEGATO, MD: Well, it's quite interesting. They're different at the macro and the micro level. Women have smaller hearts and smaller arteries, and their hearts beat faster, not just because of anxiety. They still beat faster even during sleep. Probably independent of body size, we think there's a difference in the intrinsic rhythmicity of the pacemaker of the heart in women. Also at the level of the molecule, if you will, there are different protein channels in some respects in the cardiac cell membrane that regulate the time that it takes that it takes the heart to relax after each beat. So women's hearts, in a sense, take longer to relax than men's
DAVID R. MARKS, MD: What is the clinical significance of this?
BENJAMIN LEWIS, MD: The clinical significance is that you're dealing with a heart that has four chambers and four valves in men and women. When you go to do diagnostic testing and we're looking for coronary artery disease, which is our big killer, the exercise tests react differently. The size of the heart is different in terms of the amount of heart mass per unit area. The way the mechanics of the heart are different, both at rest and with exercise, and finally, some of the imaging studies are very different. There remains a bias against women being referred for angiography. It carries all the way throughout diagnostic testing. I think we're addressing that with some of the cost-effective imaging studies we do now, particularly my interest in stress echo, which is that we now have a cost-effective tool for women. It's equally applicable to men. We have other imaging technologies as well. I think the big thing has to be that the interest has to be there. You have to recognize that there are differences, and you have to act appropriately. I think that applies to men and to women
DAVID R. MARKS, MD: What's a stress echo?
BENJAMIN LEWIS, MD: A stress echo is where we basically take an ultrasound image of the heart, and we then have the patient exercise and re-image with ultrasound. We can see the heart side-by-side and the differences that occur. That gives us information both about the mechanics of the heart in terms of muscle and valve function, and also about the health of the arteries
DAVID R. MARKS, MD: Dr. Legato, the symptoms that men and women have also differ with heart disease
MARIANNE LEGATO, MD: Somewhat. Twenty percent of women in the English, the Israeli and the American literature present a little differently than the classic substernal, gripping chest pain. Women will present with nausea, epigastric pain -- pain just under the breastbone -- often refer to the back, and a profound sense of a shortness of breath. You can see how such a woman might be sent out with Mylanta and Valium and be misdiagnosed as having either acute indigestion or gall bladder disease, or, even worse, an anxiety attack
DAVID R.
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