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What kind of heart attacks do young women have?

11 Oct

by Carolyn Thomas    @HeartSisters

In your average garden-variety textbook heart attack, the cause is typically a sudden lack of oxygenated blood supply feeding the heart muscle, caused by a significant blockage in one of your coronary arteries. This blockage is what doctors call the culprit lesion.

But in a new study led by Yale University cardiologist Dr. Erica Spatz, researchers remind us that although this “culprit lesion” classification of heart attack applies to about 95% of men under age 55, only 82.5% of younger women experience this kind of heart attack.(1)    Continue reading

Mandatory reporting of diagnostic errors: “Not the right time?”

27 Sep

by Carolyn Thomas    @HeartSisters

I can’t be 100% certain, but I’m betting my next squirt of nitro spray that the Emergency Department physician who misdiagnosed me with acid reflux and sent me home despite my textbook heart attack symptoms (central chest pain, nausea, sweating and pain down my left arm) did NOT voluntarily report his diagnostic error to his supervisor or to anybody else after I was correctly diagnosed much later by a different emergency doc. Continue reading

“It’s not your heart. It’s just _____” (insert misdiagnosis)

3 May

by Carolyn Thomas    @HeartSisters

It’s fair to say that you would not be reading these words had my heart attack not been misdiagnosed with a cheerful “You are in the right demographic for acid reflux!”  Had I been correctly diagnosed, admitted and appropriately treated during that first trip to the Emergency Department, I would likely never have started this blog in 2009. Nor would I be still writing years later about female heart patients being misdiagnosed in mid-heart attack.

We know that women continue to be under-diagnosed – and then under-treated even when appropriately diagnosed – compared to men presenting with cardiac symptoms.  In fact, as reported in the New England Journal of Medicine, female heart patients in their 50s and younger are seven times more likely to be misdiagnosed than our male counterparts.(1)

Here’s my latest round of true tales from women whose cardiovascular disease is still being missed:    Continue reading

Slow-onset heart attack: the trickster that fools us

19 Apr


by Carolyn Thomas    @HeartSisters

As I’ve noted here previously, there were a number of very good reasons that I believed that Emergency Department physician who sent me home with an acid reflux misdiagnosis. Despite my textbook heart attack symptoms of central chest pain, nausea, sweating and pain down my left arm, these reasons included:

1.  He had the letters M.D. after his name;

2.  He misdiagnosed me in a decisively authoritative manner;

3.  I wanted to believe him because I’d much rather have indigestion than heart disease, thank you very much;

4.  The Emergency nurse scolded me privately about my questions to this doctor, warning me: “He is a very good doctor, and he does not like to be questioned!”  (The questions I’d been asking included, not surprisingly: “But Doctor, what about this pain down my left arm?”);

5.  Most of all, what I had always imagined a heart attack looking like (clutching one’s chest in agony, falling down unconscious, 911, ambulance, sirens, CPR) was not at all what I was experiencing. Instead, despite my alarming symptoms, I was still able to walk, talk, think and generally behave like a normally functioning person, i.e. one who is definitely NOT having a heart attack!*

So it all made sense to me as I was being sent home from Emergency that day, feeling very embarrassed because I had clearly been making a big fuss over nothing.

My experience, however, might have been what researchers in Ireland refer to as “slow-onset myocardial infarction”.   Continue reading

Words matter when we describe our heart attack symptoms

16 Nov

by Carolyn Thomas     @HeartSisters

When I interviewed Dr. Catherine Kreatsoulas* about the research paper she presented last month in Vancouver at the Canadian Cardiovascular Congress(1), she mentioned her previous heart study that caught my attention.

I was surprised by her explanation from that earlier research on how some women describe their chest pain during a heart attack (2), as she told me:  .   .
Continue reading

How gender bias threatens women’s health

26 Oct

by Carolyn Thomas  @HeartSisters Three years ago, I attended the 64th annual Canadian Cardiovascular Congress – not as a participant, but with media accreditation in order to report on the proceedings for my blog readers.  I arrived at the gorgeous Vancouver Convention Centre feeling excited to interview as many of the cardiac researchers attending this conference as I could squeeze into my 2-day schedule – particularly all the ones studying women’s heart disease.  I was gobsmacked, however, when conference organizers in the Media Centre told me that, out of hundreds of cardiology papers being presented that year, I’d be able to “count on one hand” the number of those studies that had anything even remotely to do with the subject of women and heart disease. Essentially, that appalling gender gap then became the Big Story of the conference for me. And every one of those four lonely little studies shared a conclusion that I already knew: when it comes to heart disease, women fare worse than men do.*  See also: The Sad Reality of Women’s Heart Disease Hits Home.

But already, I can tell that this weekend’s annual Congress (once again back in Vancouver) should do better.  This year, the 192-page conference program lists over a dozen studies reporting specifically on women’s experience of heart disease.(1)  Sounds good – until you remember that it’s a puny drop in the bucket for an international conference where over 500 original new scientific papers are being presented about a diagnosis that has killed more women than men every year since 1984. Continue reading


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