In her book, “The Heart Speaks, A Cardiologist Reveals the Secret Language of Healing,” Mimi Guarneri, M.D., FACC, warns that today’s woman has gained equality in the area of heart disease.

“We know that it’s not just a man’s issue - now we have to get women and their doctors to wake up,” she said in a recent interview.

“I can’t tell you how many times a woman will bring her husband to me for a cardiac evaluation, and she hasn’t had anything other than mammograms for the last five years.”

Women tend to be caregivers, put themselves last and not complain even when they have symptoms of an ailing heart, the doctor says.

But even when they do speak up, women may not be taken seriously.

“I got to see it early on, and throughout my career,” says Dr. Guarneri, who was 8 years old when her own mother died of a heart attack.

“Women are not text book examples of cardiovascular disease. So when a healthy looking, slim woman comes in, we tend to think of everything else but the heart.”

She urges women to have cholesterol levels, blood pressure, diabetes and other risk factors checked.

But it’s not always physical, measurable data that explains why the heart – “the seat of the soul” to the ancient Egyptians and Greeks – is often the place where trouble strikes.

“Show me a woman who has lost a child or a woman in a bad relationship, and I will show you a woman who has a hard time with her will to live.”

In her book, the doctor shows how such situations have direct effect on the physical heart. She refers to a medical condition called stress cardiomyopathy, or “broken heart syndrome,” that has all the symptoms of heart failure and occurs in people who are generally healthy and experiencing intense emotional stress.

“Anger, hostility, anxiety and depression are important emotions related to heart health in both sexes,” Dr. Guarneri says.

“I learned over time that women can be very angry. They can have road rage sometimes worse than men.”

And while there’s an epidemic of diabetes and obesity in women, occasionally even without the buildup of cholesterol in the body, a woman can have a heart attack just from stress and adrenalin, she said.

As founder and medical director of Scripps Center for Integrative Medicine, Dr. Guarneri promotes a holistic approach to treating women with heart disease.

“I called my book ‘The Heart Speaks’ because the body speaks,” she explains.

“If we keep putting ourselves in stressful situations, unhealthy environments and unhealthy relationships, the body will eventually break down in the form of a heart attack, headache, irritable bowel syndrome, muscle spasms, etc.”

“We look at the underlying causes for high cholesterol, not just that it’s high. Is a woman depressed or stressed? Does she have a purpose in life and healthy relationships? Does she feel fulfilled and supported?”

Yoga, meditation, biofeedback, nutrition education, support groups and counseling are some of the holistic tools that can help prevent and treat heart disease, she says.

“You sit in a chair with four legs – body, mind, emotion and spirit. Cut off one leg and the chair begins to wobble,” the doctor says.

“Look into your life every day and ask, what have I done for each of those aspects today.”