Lori Kupetz looks younger than her 40 years, especially when shehula-hoops in front of her Sherman Oaks home with daughters Sophie,9, and Zoe, 7. No one would ever guess that earlier this year, thisthin vegetarian who doesn't smoke underwent a triple bypass.
'I just don't fit the bill of someone who would have heartsurgery,' says Kupetz, who is now out to spread the word aboutcardiovascular disease from a female perspective. 'But heart diseasekills women more than anything else. It's not just a man's disease.'
And sadly, for many women, it often goes unnoticed.
'It's very tragic, but unfortunately two-thirds of women willactually die of heart disease and not know they have a problem,'says Dr. Lisa Matzer, medical director of Glendale Adventist MedicalCenter's Outpatient Cardiac Services Program.
Doctors and researchers say this is partly because heart diseaseaffects men and women differently.
'The symptoms women present are a lot different than the symptomswe typically see in men,' says Matzer. She says the most common forwomen include weakness, fatigue, shortness of breath with exerciseand just not feeling right.
In addition, tests that work for men aren't always as effectivefor women.
'Making the diagnosis of heart disease can be difficult,' Matzersays. 'The angiogram is the gold standard for men, so we assume it'sthe gold standard for women. But it only works for one-third ofwomen. We know that two-thirds of women (with heart problems) willgo in and be given a clean bill of health.'
For Kupetz, too, getting the right diagnosis proved elusive.
Her story began in February 2005. One day while hiking with afriend, she found herself doubled over with chest pains. After twomore similar episodes, she called her internist. In light of herfamily history of heart attacks combined with her own highcholesterol level, he recommended she see a cardiologist.
' 'Doctor, I'm having the pains right now,' ' Kupetz said in thecardiologist's office, while taking a standard stress test on atreadmill.
But he couldn't see any abnormalities, so he diagnosed her chestpains as non-cardiac-related and sent her to a gastroenterologist.The pattern continued.
Nearly one year, four doctors and seven major tests later, Kupetzdidn't have answers. And she was still getting chest pains fromeveryday activities like dancing with her kids or bringing ingroceries. She had stopped exercising. One doctor suggested she takeantidepressants.
Matzer hears this a lot. 'You go into my waiting room and ask whohas a Valium and they all raise their hands because they've beentold they have a psychological problem. But it's not all in theirhead. It's all in their heart.'
Kupetz finally found answers when she called Dr. C. Noel BaireyMerz, medical director of the Women's Health Program, Preventive andRehabilitative Cardiac Center, at Cedars-Sinai Medical Center in LosAngeles.
Confident that Kupetz did indeed have a heart problem afterhearing her story, Bairey Merz ordered an echocardiac stress testand an adenosine cardiac stress MRI. Both showed that Kupetz's heartwas not responding as it should.
A subsequent angiogram found three arteries with major blockages.After an attempt at angioplasty, Kupetz had triple-bypass surgery inMarch. Through it all, her family, especially Daniel, her husband of12 years, was by her side. Kupetz credits Bairey Merz with savingher life, but the doctor says Kupetz deserves praise, too.
'Lori was a positive advocate for herself. She didn't stoppursuing it or ignore her symptoms. Doctors can only do so much.They need active partners in the process.'
Bairey Merz continues to keep track of her patient's health andKupetz does her part by maintaining a regimen of statin drugs, betablockers, aspirin and prescribed doses of fish oil.
Kupetz's pain, triggered by insufficient blood flow to her heart,is finally gone. The only visible sign now is a scar on hercollarbone. Recently while she was getting dressed, her daughterprotested when she tried to hide it with a high collar.
'Every scar has a story,' her daughter told her. 'And you shouldbe proud of yours.'
Diana McKeon Charkalis, (818) 713-3760
diana.charkalis@dailynews.com
Women, ask your doctor
When visiting the doctor, sometimes women's heart health problemsmay be overlooked. Asking physicians specific questions can help geta useful discussion started. Here's a list to bring to your nextoffice visit:
What is my risk for heart disease?
What is my blood pressure? What does it mean for me and what do Ineed to do about it?
What are my cholesterol numbers? (These include totalcholesterol, LDL, HDL, and triglycerides, a type of fat found in theblood and food). What do they mean for me and what do I need to doabout them?
What is my 'body mass index' and waist measurement? Do they meanthat I need to lose weight for my health?
What is my blood sugar level, and does it mean I'm at risk fordiabetes? If so, what do I need to do about it?
What other screening tests for heart disease do I need?
What can you do to help me quit smoking?
How much physical activity do I need to help protect my heart?
What is a heart-healthy eating plan for me?
How can I tell if I may be having a heart attack? If I think I'mhaving one, what should I do?
-- NIH/National Heart, Lung and Blood Institute
