Doctors, Women, and Heart Disease

Women Outpace Men in Deaths from Heart Attacks

Despite popular belief, heart disease is not a male-dominated condition. To the contrary, it is the leading cause of death for women worldwide, accounting for about 20% of all female deaths in the United States. Similarly, women are more likely than men to die of a heart attack.

One of the reasons women outpace men in deaths from heart attacks is due to the disparity in medical care based on gender.

• Women often experience different symptoms. While chest pressure (common symptom in men) may be present, women’s symptoms tend to be more diverse and can include shortness of breath, nausea, pain in the chest, abdomen, or back, fatigue, or dizziness.
• Research on women still lags.  Initially, women were not included in clinical trials, and they are still underrepresented, despite their higher mortality rate. Consequently, physicians often fall back on knowledge gleaned from male-centric research, missing or minimizing critical symptoms of a woman’s impending heart attack.
• Gender bias. Studies have demonstrated a gender gap when it comes to diagnosing heart attacks in women with physicians less likely to consider heart disease as a cause of reported pain or discomfort. Speaking of pain, according to recent studies, the significance of women’s pain is routinely minimized or dismissed when compared to men. If it is addressed, the studies found providers “prescribed more psychotherapy for female and more pain medicine for male patients.” In other words, women are often told by doctor’s that their symptoms are in their head.
• Women don’t take their own symptoms seriously.  Women have been found to be more likely to minimize their own symptoms, perhaps because of conventional wisdom from male-skewed studies or the result of conditioning by the medical community and society at large.

Even when women do raise concerns about their symptoms, they are often not taken seriously. Consider this story of a 45-year-old woman who visited her doctor and a cardiologist with heart palpitations and edema (swelling). She even took the extra step of tracking her symptoms in a spreadsheet, but the cardiologist did not even consider the information. Instead, he told her there was nothing wrong with her heart and advised her to reduce her stress. Three weeks later, she suffered a major heart attack due to a total blockage in a major artery (called a “widow-maker” event), something the cardiologist should have detected.

If you are a woman, self-advocacy is not only important, it is imperative. All women should educate themselves to:

• Understand the risk. Simple awareness of the prevalence and seriousness of heart disease in women will help you in considering your own symptoms.
• Know the potential symptoms of heart disease in women. Understanding how heart disease can manifest itself before you experience symptoms will help in promptly getting help.
• Not hesitate. If you have troubling symptoms that may be signs of a heart attack, call 9-1-1 and seek immediate medical attention.

Heart disease is the number 1 killer of women. If you or a family member have been the victim of an undiagnosed heart condition, please contact us to discuss possible next steps.