by Carolyn Thomas ♥ @HeartSisters
At the WomenHeart Science & Leadership Symposium last fall, Mayo Clinic cardiologists told us that, when it comes to women, heart disease is much more than an equal opportunity health threat. Women with heart disease are underdiagnosed (and undertreated even when accurately diagnosed) compared to men presenting with the same condition. And we also have more deadly outcomes compared to men.
Did you know that more women than men die of heart disease each year in North America? What I found particularly appalling was a 2005 American Heart Association study that found only 8% of family doctors were aware of this fact, and (even worse!) only 17% of cardiologists were aware.
Here are some other examples that may help to explain gender bias in diagnosis and treatment of women’s heart disease:
- In the past, most of the major cardiovascular research studies were conducted only on men.
- Both physicians and patients often think of women’s heart attack symptoms as being non-cardiac-related.
- Women may avoid or delay seeking medical care.
- Women’s older age and their more advanced stage of coronary heart disease can affect the treatment options available.
- Some cardiac diagnostic tests, like the treadmill stress test, may be less accurate in women, especially for ‘single-vessel’ heart disease that’s more common in women than in men.
Source: Is It Gender Difference or Gender Bias? © 2009 American Heart Association
IMPORTANT UPDATE:
January 31, 2016: The American Heart Association released its first ever scientific statement on women’s heart attacks, confirming that “compared to men, women tend to be undertreated“, and including this finding: “While the most common heart attack symptom is chest pain or discomfort for both sexes, women are more likely to have atypical symptoms such as shortness of breath, nausea or vomiting, and back or jaw pain.”
See also:
- Misdiagnosis: the Perils of “Unwarranted Certainty”
- Seven Ways To Misdiagnose a Heart Attack
- The ’18 Second Rule’: Why Your Doctor Missed Your Heart Attack Diagnosis
- Things Your Doctor May Not Know
- Experts: Why So Wrong So Often?
- How to Be a Good Patient
- Seven Ways to Misdiagnose a Heart Attack
- It Wasn’t Heart Disease – But What Was It?
- What Doctors Really Think About Women Who Are ‘Medical Googlers’
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Heart Sisters 
Thanks Carolyn for bringing the issue of gender “difference” and gender “bias” to the table! It’s been long overdue!!
I have Adult Congenital Heart Disease, but it took over two years for my first heart defect to be detected. It took another two years before the other two heart defects were detected. Why? Because I am a woman, and did not fit the “medical textbook” explanation of heart disease.
I am a non-smoker, athletic, no family history other than my father who had an angioplasty 40+ years ago, non-diabetic, 5’2 and 107 pounds, and otherwise healthy.
I cannot begin to tell you how many cardiologists wanted to put me on Paxil, or some other form of anti-depressant, stating that it was not my heart. I fired four of them before I found Dr. Lynne Wagner…THANK GOD!!!!
I just finished writing a book about this issue entitled “Can You Hear Me Now : or do I need to yell into your stethoscope?” If we all work together to bring awareness to the issue of gender differences/bias, then maybe someday, heart disease will not be the number one killer of women!!!!
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Thanks Cyndi – love-love-love the title of your new book! Can you tell me when/where it will be available? Would love to help promote it here to my Heart Sisters readers – and 10% of your book proceeds will go directly to support WomenHeart: The National Coalition for Women With Heart Disease. Way to go!
Also, I just watched your fantastic panel interview with Dr. Sharonne Hayes in Nashville. This is well worth viewing – well done, Cyndi!!
Cheers,
C.
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If women wait before seeking help during heart attack symptoms, it hardly matters what tests and operations may be available at the hospital. We have to get help IMMEDIATELY or else we are screwed, and worse, we are doing it to ourselves. Great article, good information. Thanks for this, Carolyn.
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You are so right, Evangelina. See also Knowing & Going for more on women’s well known treatment-seeking delay behaviours.
Cheers,
C.
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Thanks Krista!!
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I just have to say “thanks” on behalf of all women who have or may have heart issues. I am blessed thus far with low blood pressure and a healthy heart, and with the early detection of my high cholesterol and sites like yours I am hoping to avoid heart disease. I have marked the site on my favorites and plan to visit often. I will also share with my friends.
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