Byline: Diana McKeon Charkalis Lifestyle Editor
Lori Kupetz looks younger than her 40 years, especially when she hula-hoops in front of her Sherman Oaks home with daughters Sophie, 9, and Zoe, 7. No one would ever guess that earlier this year, this thin vegetarian who doesn't smoke underwent a triple bypass.
``I just don't fit the bill of someone who would have heart surgery,'' says Kupetz, who is now out to spread the word about cardiovascular disease from a female perspective. ``But heart disease kills 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 will actually die of heart disease and not know they have a problem,'' says Dr. Lisa Matzer, medical director of Glendale Adventist Medical Center's Outpatient Cardiac Services Program.
Doctors and researchers say this is partly because heart disease affects men and women differently.
``The symptoms women present are a lot different than the symptoms we typically see in men,'' says Matzer. She says the most common for women include weakness, fatigue, shortness of breath with exercise and just not feeling right.
In addition, tests that work for men aren't always as effective for women.
``Making the diagnosis of heart disease can be difficult,'' Matzer says. ``The angiogram is the gold standard for men, so we assume it's the gold standard for women. But it only works for one-third of women. We know that two-thirds of women (with heart problems) will go 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 a friend, she found herself doubled over with chest pains. After two more similar episodes, she called her internist. In light of her family history of heart attacks combined with her own high cholesterol level, he recommended she see a cardiologist.
`` `Doctor, I'm having the pains right now,'' ' Kupetz said in the cardiologist's office, while taking a standard stress test on a treadmill.
But he couldn't see any abnormalities, so he diagnosed her chest pains as non-cardiac-related and sent her to a gastroenterologist. The pattern continued.
Nearly one year, four doctors and seven major tests later, Kupetz didn't have answers. And she was still getting chest pains from everyday activities like dancing with her kids or bringing in groceries. She had stopped exercising. One doctor suggested she take antidepressants.
Matzer hears this a lot. ``You go into my waiting room and ask who has a Valium and they all raise their hands because they've been told they have a psychological problem. But it's not all in their head. It's all in their heart.''
Kupetz finally found answers when she called Dr. C. Noel Bairey Merz, medical director of the Women's Health Program, Preventive and Rehabilitative Cardiac Center, at Cedars-Sinai Medical Center in Los Angeles.
Confident that Kupetz did indeed have a heart problem after hearing her story, Bairey Merz ordered an echocardiac stress test and an adenosine cardiac stress MRI. Both showed that Kupetz's heart was not responding as it should.
A subsequent angiogram found three arteries with major blockages. After an attempt at angioplasty, Kupetz had triple-bypass surgery in March. Through it all, her family, especially Daniel, her husband of 12 years, was by her side. Kupetz credits Bairey Merz with saving her life, but the doctor says Kupetz deserves praise, too.
``Lori was a positive advocate for herself. She didn't stop pursuing 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 and Kupetz does her part by maintaining a regimen of statin drugs, beta blockers, 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 her collarbone. Recently while she was getting dressed, her daughter protested when she tried to hide it with a high collar.
``Every scar has a story,'' her daughter told her. ``And you should be 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 problems may be overlooked. Asking physicians specific questions can help get a useful discussion started. Here's a list to bring to your next office visit:
What is my risk for heart disease?
What is my blood pressure? What does it mean for me and what do I need to do about it?
What are my cholesterol numbers? (These include total cholesterol, LDL, HDL, and triglycerides, a type of fat found in the blood and food). What do they mean for me and what do I need to do about them?
What is my ``body mass index'' and waist measurement? Do they mean that I need to lose weight for my health?
What is my blood sugar level, and does it mean I'm at risk for diabetes? 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'm having one, what should I do?
-- NIH/National Heart, Lung and Blood Institute
CAPTION(S):
4 photos, box
Photo:
(1 -- cover -- color) ROUND AND ROUND
Challenges of diagnosing heart disease in women
(2) Lori Kupetz of Sherman Oaks has no problem playing with her children, Sophie, 9, left, and Zoe, 7, after undergoing triple-bypass surgery earlier this year at the age of 39. For months before her operation, doctors did not see her problem as heart-related.
(3) Spending time being active with daughters Sophie, left, and Zoe, right, is high on Kupetz's list since bypass surgery increased blood flow to her heart and stopped the regular chest pains that led her to curtail any strenuous activity.
(4) Kupetz saw four doctors and had seven major medical tests before her heart disease was diagnosed. Before then, physicians attributed her symptoms to, among other things, gastroenterological problems and depression.
Box:
Women, ask your doctor (see text)
