Cardiology: Women and Heart Diseases

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Table of Contents

Introduction
Women’s Health and Myocardial Infarction
Implications for High Mortality Rate
Nurse Education
Impact of Obamacare on Preventative Health Care.
How I will Address the Issue
Conclusion
References

Introduction

Cardiovascular diseases are one of America’s most expensive groups of diseases due to the level of care needed during hospitalization for cardiac surgery. Myocardial infarctions, also referred to as heart attacks, are some of the most dangerous cardiovascular diseases making a significant contribution to the mortality of the American population and imposing a great financial burden on the nation’s health care system. While heart disease affects both men and women, gender differences play a role in the manifestation and outcomes of cardiovascular diseases. With this in mind, this paper will set out to analyze myocardial infarction as it relates to women.

Women’s Health and Myocardial Infarction

The prevalence in incidents of myocardial infarction (MI) is determined by gender with men experiencing higher incidents of MI than women do. Even so, there is an increase in the percentage of women experiencing incidents of MI as age increases. Research indicates that in older women, the risk factor for MI is stronger in women compared to men. Leppert and Peipert (2004) propose that this might be because the risk factors for heart attack are greater in postmenopausal women or that the men who are likely to suffer from this have already died at an earlier age. The suggestion that older men may have died before being afflicted by this condition is supported by Norekval et al. (2009) who note that the majority of older persons are women.

Once a woman has suffered from an incident of MI, her future health outcomes are greatly compromised. A study by Tillmanns et al. (2005) reveals that men have better chances of recovery after surgery or treatment for MI compared to women. The smaller arterial size in women increases their risk of angioplasty following treatment to counter MI. Incidents of internal tears and coronary dissections in women lead to reduced quality of life following an MI event.

Implications for High Mortality Rate

The mortality rate for MI is significantly high and up to 50% of the people who experience a heart attack in the US die. Women suffer from a disproportionate mortality rate with the survival rates for women following an incident of MI being lower than those of men are. A study on the long-term mortality rate revealed that women had a mortality rate of 23% in 4 years while men had a significantly lower rate of 15% (Tillmanns et al., 2005). While heart disease poses significant risk for women, most people are ignorant of this fact. Ivarsson (2011) documents that coronary heart disease (CHD) is the leading cause of death among women with women being eight times more likely to die of heart disease than breast cancer. The prevalence of heart disease in women can be blamed on the fact that this condition in women is “under diagnosed, undertreated, and under researched” (Tarlea, et al., 2009, p.375).

A lack of extensive research on heart diseases has led to the high mortality rate currently experienced. Because of the many research studies commissioned for heart disease in men, the classical risk factors have been identified. The mortality rate has therefore been decreased as efforts have been taken to intervene on these risk factors, which include smoking and hypertension. Without the same extensive research for women, risk factors for this gender remain unknown and interventions on risk factors can therefore not be implemented in order to decrease mortality (Tarlea, 2009).

Nurse Education

MI has significant costs hence tackling this ailment through preventive strategies would be most desirable. To assist in the implementation of preventive strategies, nurses have been provided with specific education related to heart disease prevention. Davidson (2011) documents that nurses are constantly being trained to improve their competency in diagnosing heart diseases in patients at the earliest stage possible. Such education is important considering the fact that diagnosing CHD in women presents a greater challenge than performing the same diagnosis for men. Leppert and Peipert (2004) states that some of the reasons for this variance is the women’s anatomy and size.

Nurses are also taught to provide comprehensive care to individuals diagnosed with heart diseases and this care covers inpatient services to the implementation of community-based programs to help maintain health once a person has been discharged. Davidson (2011) reveals that nurses are trained to make use of evidence-based practice when handling CVD, which may become increasingly complex. By utilizing evidence-based practices, nurses are able to provide the most relevant care therefore increasing the likelihood of favorable outcomes for the patient.

Impact of Obamacare on Preventative Health Care.

The Affordable Care Act (popularly referred to as Obamacare) has a huge bearing on preventative services offered in the country. The Act requires insurance companies to cover preventative services that may be required to improve the health outcomes of an individual. Obamacare will increase access by people to health insurance products leading to equitable coverage (Obamacare Facts, 2013). When this is achieved, women who are at risk will be able to access the appropriate health services in a timely manner therefore decreasing the incidents of MI among women. Ioannides et al. (2010) assert that “preventative strategies for cardiovascular diseases have the potential to significantly reduce morbidity, mortality and costs” (p.534). If preventive care is adopted, the enormous costs needed to hospitalize the patient after the initial acute event and subsequently cover out of hospital medical services can be avoided saving the government millions of dollars.

Preventative health care entails providing individuals with information that will lead to lifestyle changes. Since some lifestyle choices such as smoking increase the risk for heart disease, a healthcare system that focuses on preventative measures will help promote healthy lifestyles. Additionally, the community members will be educated on how to reduce risks of heart disease. Education is very important especially for women who are postmenopausal of who have experienced a CVD event since these two groups are most likely to have events of MI.

How I will Address the Issue

Survival rates for MI are increasing and a growing number of people are living longer even after suffering from heart attacks. The nurse can help this group of survivors improve their quality of life. As a care provider, it will be my role to provide my clients with direct care aimed at improving their health outcomes. This care will include coming up with the most effective medical management strategy for my patients. This is an important role since medical management is the first line of therapy once heart disease has developed in a woman (Leppert & Peipert, 2004).

As a nurse, I will act as a teacher and provide patients with useful information on their health conditions especially concerning hearth diseases. I will also assist patients who have suffered from MI to better interpret their ongoing symptoms and therefore avoid stress. Ivarsson (2011) notes that most patients live in constant fear of a second MI. These fears increase the stress that the women explain and a lack of knowledge leads to unnecessary panic. Invariably, MI brings about new physical and mental challenges for the afflicted individual.

The nurse is supposed to act as an advocate of change, championing various causes on behalf of his/her clients. As such, I will endeavor to advocate for the promotion of preventative health services for women to reduce risks of heart disease. As a member of the medical profession, I will help in the development of optimal strategies to aid in the prevention and treatment of heart disease among the population. I will also promote research to expand the knowledge base of MI amongst women in the country.

Conclusion

This paper set out to analyze women’s health as it relates to myocardial infarction and the role that preventative health care can play in mitigating heart diseases. The paper notes that while MI has traditionally been seen as a male disease, its impact on women is more marked. Lack of attention and research focused on women has led to higher mortality rates for women. The recognition of the significance of MI over the past decade has led to changes including education of nurses on how to take care of MI patients.

References

Davidson, M.P. (2011). Preparing Nurses for Leadership Roles in Cardiovascular Disease Prevention. Journal of Cardiovascular Nursing, 26 (4), 56-63.

Ioannides, L.L., Kelly, M., Ashton, E., Stoelwinder, J., & McNeil, J.J. (2010). Cost of Myocardial Infarction to the Australian Community. Clin Drug Investig, 30(8), 533-543.

Ivarsson, B. (2011). Women’s experience of a myocardial infarction: 5 years later. Scand J Caring Sci, 25 (1), 459–466.

Leppert, P.C. & Peipert, J.F. (2004). Primary Care for Women. Boston: Lippincott Williams & Wilkins.

Norekval, T.M., Fridlund, B., Moons, P., Nordrehaug, E.H. Hanestad, R.B. (2009). Sense of coherence—a determinant of quality of life over time in older female acute myocardial infarction survivors. Journal of Clinical Nursing, 19 (1), 820–831.

Obamacare Facts (2013). ObamaCare Facts: Facts on the Obama Health Care Plan. Web.

Tarlea, M., Deleanu, D.A, Zarma, L., Platon, P., & Carmen, G. (2009). Risk Profile in Women with Acute Myocardial Infarction. Rom J. Intern. Medicine, 47(4), 371–380.

Tillmanns, H., Waas, W., Voss, R., & Crete, L. (2005). Gender differences in the outcome of cardiac interventions. Herz, 30(5), 375-89.

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