There are several important considerations re women's heart disease and gynecological issues - and there is a surprising amount of indifference and misinformation (old, outdated info) by doctors to women heart patients - when, for example, giving a woman with heart disease the advice to have her ovaries removed (assuming there is no cancer or endo) in conjunction with a hysterectomy.
Here is an article that covers the major concerns regarding the ovaries issue and explains why all women (and those with heart disease, especially) regardless of whether menopausal or not - should keep their healthy ovaries:Rationale for Ovarian Conservation by Donna Shoupe MD
The current studies show that neither HRT or ERT is recommended for women with active heart disease. One study was terminated prior to completion because it was already clearly shown by mid-study that the risk of stroke skyrocketed for high-risk women using HRT/ERT, and the risk of heart attack was also elevated.
Check out these 2001 stats for the leading causes of death in women:
361,000 - heart disease
100,000 - stroke
66,000 - lung cancer
63,000 - copd (a pulmonary disease)
41,000 - breast cancer
13,900 - ovarian cancer
And here is the site where the above stats came from: "Women's Heart Truth"
Anemia caused by DUB (dysfunctional uterine bleeding) can cause heart failure.
The symptoms of acute anemia and heart failure are very similar and easily confused. Acute anemia should not be allowed to continue on for extended periods of time.
Another particular concern for premenopausal women who may be on blood thinners (due to a stent or a mechanical valve) is that you would likely have to have emergency surgery or at least hospitalization if you had a fibroid, (as only one example) that caused extremely heavy bleeding, and in fact you could lose your life if this happened out of reach of help.
In heart valve replacement surgery - the choice of valve type needs to be made in consideration with whether pregnancy is planned in the future. Lifetime blood thinners are required for mechanical valves, but not for porcine (biological) type valves.
I have read about
recent cases of women who tragically did not know, and were not told this at the time of their
open-heart surgery - and had to have another
open-heart surgery to replace the valve type so they could have children, because blood thinners are incompatible with pregnancy.
As women with heart disease, we have to be especially careful - and be very proactive in doing our own research so we have the information we need to make some very important decisions. We have to do this because the medical community tends to be very specialized and often does not connect the dots between GYN issues and women with active heart disease.