Coronary heart disease is the No. 1 killer of both men and women in the United States. "Unfortunately, heart disease is ridiculously common," says Robert Ostfeld, MD, an associate professor of clinical medicine at Montefiore Medical Center in New York City. "And the message about heart risk in women may not be as appreciated as it should be. It's six to seven times more likely for a woman to die from heart disease than from breast cancer," Dr. Ostfeld says. "Obviously, it'd be better not to have either one, and that's why it's extremely important to screen for both."
Whether you're a man or a woman, raising your awareness about heart disease and understanding your own risk factors are the first steps to prevention. The American Heart Association recommends assessing your heart disease risks as early as age 20, and then working to keep your modifiable risk factors low by adopting a heart-healthy lifestyle that includes regular doctors' visits, physical activity, and a balanced diet.
Minimizing stress, moderating alcohol consumption, and not smoking are also crucial to promoting heart health, as is managing any known health conditions that may put you at greater risk for heart disease, such as weight/obesity, diabetes, high cholesterol, or high blood pressure. For people older than 40 or people who suspect they have multiple risk factors, it's especially important to discuss heart health with your doctor.
Here's what you can expect from your examination:
Personal Medical History
In order to assess your personal risk for developing heart disease, your doctor will want to get your complete medical history, including details about:
- Symptoms that might suggest trouble in your heart or blood vessels, such as shortness of breath, chest or arm pain, leg swelling, dizziness
- Medications you are currently taking
- Your diet
- Your physical activity level
- Smoking or alcohol use
- Your stress level
- Any other health issues
- Family medical history. Risk assessment also takes into account whether your family has a history of there's a history of heart disease. Children whose parents developed coronary heart disease before age 55, or who have siblings or second degree relatives with early heart disease are more likely to develop the disease themselves. Additionally, African-Americans, Mexican-Americans, American Indians, and other Native Americans have a greater risk of heart disease than Caucasians, according to cardiovascular experts at the U.S. Food and Drug Administration (FDA).
- Documentation you have from previous medical visits. This could include blood test results or heart function evaluations, such as echocardiograms (ECHOs), electrocardiograms (EKGs), chest magnetic resonance imaging scans (MRIs), or cardiac stress tests.
Careful Physical Assessment
A detailed physical exam will help your doctor get a better sense of your current state of health. The examination will probably entail:
- Assessing your general appearance, include your coloring, relative comfort, breathing
- Measurement of your vital signs, especially blood pressure, heart rate and rhythm
- Visually examining the blood vessels in your neck and using a stethoscope to listen to them
- Palpating, or pressing one finger against blood vessels in your neck or leg arteries (or other parts of your body) to check your pulse
- Palpating the heart — your doctor will place his or her hand over your heart to see if any abnormalities are noted
- Listening to your heart with a stethoscope to evaluate your heart sounds, listen for murmurs, clicks, abnormal rhythms, missed or extra beats, or other abnormalities
- Other parts of your body (abdomen, skin, eyes, limbs) will also be evaluated, because they may provide clues to the presence of heart disease
- Blood work may be ordered in order to evaluate cholesterol and triglyceride levels, to assess CRP (which reflects the degree of inflammation in the arteries), and to screen for diabetes or other medical issues
- A possible EKG or other heart function diagnostic screening tests
Medically reviewed by: Rosalyn Carson-DeWitt, MD, writer and editor of hundreds of medical articles for print, Internet, and CD-ROM products. Review date: November 4, 2008.