Ask a Texas Heart Institute Doctor
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Question:
Will you help me understand more about my symptoms? I have an LAD muscle bridge and new onset of menopause.
I have recently been diagnosed with "mild mid vessel disease and muscle bridging 30 - 40% of the LAD". I have a history of high cholesterol (7.8 - HDL 1.75, LDL 5.77 and triglyceride 1.14). Blood pressure is within the normal range. I am 56 years of age and have just started menopause. Symptoms include night sweats, daytime flushing and some heaviness in the chest. I'm a little more tired than usual and have recently noticed some shortness of breath on exertion (going upstairs in particular). Otherwise I am healthy. I have been prescribed statins and calcium blockers but wish to find out more about my condition and the impact menopause may have on my heart, before I start on medicines. My doctor says these have been prescribed for prevention. Can you let me have your opinion please. Thanking you.
submitted by Rosaleen from Ireland on 11/15/2015
Answer:
by Texas Heart Institute cardiologist, Roberta C. Bogaev, MD
Dear Rosaleen,
Thank you for contacting Ask a Heart Doctor at the Texas Heart Institute. 
Heart disease risks increase for both women and men as we age. Menopause does not cause cardiovascular disease but often occurs at the same time as other risk factors increase. More than one in three women suffer from cardiovascular disease, which is the number one killer of women and men. The decline in estrogen with menopause can attribute to stiffness of blood vessels and the heart. Furthermore, recent studies have shown that the loss of estrogen attributes to relaxation of the posterior pharynx, placing women at higher risk of obstructive sleep apnea following menopause. Daytime somnolence or increase fatigue can be a subtle symptom of sleep apnea. High blood pressure also occurs in women following menopause.
The coronary artery bridging of your left anterior descending artery, which is due to a segment of the artery that is under the heart muscle rather than on top, is common in women and can contribute to chest pain and even your shortness of breath with exertion. The calcium channel blocker that you were prescribed helps the heart to relax and not pinch the segment of artery under the heart muscle with each heart contraction. Let your doctor know if you continue to have chest pain as the dose may need to be increased or another medication, such as a beta blocker, can be prescribed.
Statin drugs have been very effective in reducing the LDL cholesterol and reducing inflammation, which leads to plaque rupture and heart attacks. Many studies have shown a reduction of heart attacks and deaths in patients who take statin drugs. Unfortunately, statin drugs can have side effects. You will need to have your liver enzymes check routinely with a blood test. The muscle aches which can occur on statins can often be prevented by taking supplemental vitamin D and coenzyme Q10. Please discuss any side effects with your physician.
Daily exercise is one of the most effective ways to prevent heart attacks, strokes, and even dementia. Exercise increases your HDL cholesterol (which is protective) and lowers your LDL cholesterol. The HDL cholesterol often decreases in women following menopause.
Stay in tune to your body and report any new symptoms to your physician. With knowledge, lifestyle modifications, and medical therapy, you can prevent heart disease and stroke.
Best in Health,
Dr. Roberta Bogaev
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Updated December 2015
