This month's continuing education (CE) articles aim to teach nurse practitioners (NPs) to consider all patient populations when diagnosing and prescribing. This month's CE article on chest pain in women by Brenda M. Eden offers new insights about why we question differences between women and men presenting with chest pain. Remember the case of Yolanda King, who appeared to be more exhausted than usual as she moved through her busy schedule on May 15, 2007. When she arrived at her final destination for the evening, she stepped in the door and collapsed.1
According to family disclosures, the cause of death was presumed, but never confirmed, to be a heart condition, leaving the family in disbelief because Ms. King had never indicated any concerns about heart health. While her death made world news, the deaths of countless other women who have succumbed prematurely to heart disease are not broadcast as loudly.
[black small square] Beyond the Classic Symptoms
Cardiovascular disease (CVD) is an insidious killer. Hypertension, stroke, myocardial infarction, and coronary artery disease are familiar manifestations of CVD. Signals from the body, especially in women, may not fit the "classic" presentation for heart disease, are often attributed to other conditions, and definitely present challenges for healthcare providers as they try to decipher the signs and symptoms. If heart disease is not included in the differential, the opportunity for early diagnosis and early intervention is sure to be missed.
National programs make every effort to raise awareness about heart disease in women. The American Heart Association (AHA) has designated February as National Heart Month, and several organizations support AHA's ongoing Go Red for Women campaign.2
As NPs who promote prevention to patients and routinely assess risk factors for CVD, let us not forget young women. Age does not automatically protect against heart disease.
NPs can take advantage of opportunities to educate young women on prevention of CVD during counseling for contraception, nutrition, weight management, physical activity, emotional health, or any other appropriate time. Encouraging all young women to know their family medical history is another strategy to increase awareness and understanding of risk factors for CVD, and how lifestyle behaviors can either contribute to the development of CVD or decrease one's risk.
[black small square] Examining the Latest Pharmaceuticals
The medical world and pharmaceutical industry have long recognized the need to distinguish the safety of medications taken during pregnancy and lactation. As scientific advances reveal differences not only between men and women but also between subpopulations, pharmacogenetics and pharmacogenomics are expanding fields that call attention to a trend of taking individualized drug therapy to an even higher level.
The other CE article this month by Laustsen, Shaul, and Short reviews several new medications approved in 2007. The authority to prescribe carries a great amount of responsibility. It is difficult to keep up with changes in drug therapy and recommendations for special considerations with new and established medications. The local pharmacist is a healthcare partner with whom I frequently consult. As we care for our various patient populations, remember the similarities, but don't forget the differences.
Jamesetta Newland, APRN, BC, FNP, FAANP, FNAP, PhD
Editor-in-Chief, [email protected]
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