Cardiovascular diseases are the leading cause of death among women and early detection and diagnosis are key to defeating the number one killer of women - heart disease. Yet, the significance of heart disease in women has been underappreciated and women are underrepresented in cardiovascular clinical research.
Women and men share common features in the manifestations and pathophysiology of heart and vascular disease, but understanding of those pathophysiological mechanism is incomplete. Although heart disease kills more women than men every year, the treatment of women’s heart disease was based – until recently – on medical research performed on men. Perhaps because women have been historically underrepresented in research studies, little was known about:
- the differences in biomarkers profile in women and men,
- the impact of pregnancy and its complications on subsequent cardiovascular diseases in the newborn and mother,
- the social determinants of health and their impact on cardiovascular outcomes in women and men,
- the relationship between nontraditional CV risk factors, such as systemic autoimmune disorders,
- the effects of psychological factors such as high anxiety and life stress on chest pain symptoms in women.
Mission of Women’s Heart Center
The mission is to offer quality care by providing preventive care, treatment and management of health related issues, with emphasis on cardiovascular health and to empower women through educational and emotional support. Most women are unaware of their risk for heart disease, and commonly used clinical risk stratification tools underestimate their lifetime risk.
A cardiovascular preventive approach for women with unknown coronary disease, aged 35-60 years, including state-of-the-art screening and testing, has been defined together with a psychological evaluation. Women receive a Patient Health Questionnaire, the Beck Depression Inventory, a State-Trait Anxiety Inventory Form Y1-Y2 as part of a larger psychosocial questionnaire to assess both cognitive and physical symptoms of depression. Additional questions assess whether participants had ever received treatment from a psychologist or psychiatrist for an anxiety disorder. CV and gender-related CV are collected and evaluated together with metabolic, genetic and inflammatory tests.
The Monzino Women’s Heart Center is a state-of-the-art facility with:
- on-site diagnostic capabilities for heart disease in women including stress tests, EKGs and echocardiograms (heart ultrasounds),
- exam rooms that are comfortable and warm,
- dedicated staff trained specifically in women’s heart disease issues,
- physicians, nurse practitioner, dietician, medical technicians and an exercise physiologist.
Goals of the Women’s Heart Center
- educating women about the prevalence of heart disease and its risks,
- identifying women at risk for heart disease,
- working together with each woman to improve her cardiac risk factor profile
Monzino Women Heart Center is also a forum for scientific culture, with the launch of new lines of research dedicated to specific risk factors of women and clinical studies evaluating the effectiveness of both therapies already established for man (but less applied to women) as well as promising new therapies. To date, there are no multicenter studies aimed exclusively at the women population and the number of recruited men is always higher than the percentage of women.
Our Scientific research is focused so far on acute coronary syndromes in women presenting without coronary disease (Takotsubo syndrome) in order to better understand physiopathologic insights and possible markers useful to address adequate preventive strategies. In this vein, another research pathway lays in collecting all the psychologic women characteristics well known as major cardiovascular risk factors in order to obtain correlations between psychosocial trait and the attitude to undergo prevention together with all the clinical risk factors emerged during the clinical approach.