Women are great caregivers, however are they proactive when it comes to their own health management? Heart devices for cardiac problems such as arrhythmias and heart failure have extended and improved the lives of millions of people worldwide. With the advent in science and technology, these devices have also evolved and come out as boon to heart patients, often giving them a new lease of life.

It has been established that females are at equal risk as males when it comes to heart disease. Cardiology, however, functions differently in men and women. Women are more likely than men to have multiple risk factors. Apart from common risk factors (diabetes, high blood pressure, elevated blood cholesterol levels and smoking) that may lead to cardiovascular disease in men and women, there are other factors which contribute to the risk of cardiovascular disease in women.

• Menopause and estrogen loss - estrogen, a hormone produced in a woman’s body, offers natural protection against heart disease. The loss of natural estrogen as women age may contribute to a higher risk of heart disease after menopause. If menopause is caused by surgery to remove the uterus and ovaries, the risk rises sharply.
• Birth control pills -  some oral contraceptives might pose a risk of heart disease, especially in women who smoke or have high blood pressure.
• Psychosocial stress, obesity and depression are significant risk factors which affect women more comparatively.
• Women with diabetes have an increased risk of dying from cardiovascular disease compared to men with diabetes; gestational diabetes during pregnancy also adds on to the risk factor for women.
• The use of hormone replacement therapy containing conjugated equine estrogens which was once believed to protect women against cardiovascular disease, is now known to increase cardiovascular disease.

Several types of heart disease are more common in women than in men: stroke, hypertension, endothelial dysfunction, and congestive heart failure.

Many recent medical studies share a common finding - women commonly either ignore or deny the symptoms of heart disease or heart attacks. Traditionally inclined to be caregivers and not care receivers, women tend to minimize concerns about themselves. According to an American Journal of Medicine article, women rate their cardiac disease as less severe than men do, even after taking into account other measures of cardiac disease severity. The delays in seeking treatment worsen disease and prognosis. Recognizing and admitting that one has a problem is the first and the most important step in stopping the heart disease discrimination against women.

Medical professionals also feel challenged to respond to women's milder symptoms, acting with insufficient guidelines. Women who go to hospitals complaining of chest pain or any other heart related symptom are less likely to be advised to consult cardiologist as compared to men.

Compared to men, women are less likely to receive therapies which are known to improve survival post episode of heart failure or cardiac arrest; this contributes to a higher rate of complications in women. According to studies, men at risk of cardiac arrest are the most likely to get implantable cardiac device therapy as compared to females at similar level of risk. implantable cardiac devices are small devices inserted in the chest that can detect dangerously fast rates and deliver treatment within seconds to prevent sudden death. implantable cardiac devices are now embedded with new technology that allows for full-body MRI scans among patients with these devices.

Multiple studies have deduced women benefited more than men when it comes to cardiac devices therapy. The latest case in point has just emerged over the past year: Women receive fewer implantable cardiac devices (ICDs) than men do, yet when women do receive these devices and their survival is the same or better than men's.

According to a report presented at the European Heart Rhythm Association’s EUROPACE-CARDIOSTIM 2015 by Cleveland Clinic, women make up only about one-third of patients referred for implantable cardiac devices; however, women undergoing implantable cardiac device implants survive as well as men and those treated with CRT therapy tend to survive about 30 per cent longer than men.

These findings aim at stopping the catastrophe of women not recognizing they have heart disease. Understanding and controlling the risks of heart disease can lead to improvement in health & well-being of females. Medical experts recommend implantable cardiac device use for patients who have heart failure or have survived a heart attack and have an ejection fraction of 30 per cent or less.

At a time when healthcare is most talked about topic in the society, the benefits of use of medical (cardiac) devices especially among female population should be taken up actively. Women should be encouraged to pay attention to their symptoms and opt for timely diagnosis and treatment.

(Author is consultant cardiologist & cardiac electrophysiologist, Metro Hospital, Faridabad)