by Carolyn Thomas ♥ @HeartSisters ♥ Updated May 1, 2022
I just finished reading a truly weird rant on another website, written by a man decrying the “sexism” of society because all of our male doctors are now focused only on women’s heart disease – while apparently ignoring men completely. It turns out he’s not alone in his misinformation: see also Women’s Heart Health: Why it’s NOT a Zero Sum Game.
It would surely be the fantasy dream of every female heart attack survivor if this man were actually correct about all that attention women’s heart disease is allegedly attracting. The frightening reality instead is that since 1984, the differences between men and women’s cardiac diagnoses, treatments and outcomes has continued to grow.
In the interests of enlightening the unconscious among us about All Things Cardiac, I am happy to point out an assortment of gender differences if you find yourself having a heart attack:
- 1. For women under the age of 50, heart attacks are twice as likely to be fatal as men’s.
- 2. Women are twice as likely as men to die within the first month after suffering a heart attack.
- 3. Marital stressworsens the prognosis in women with heart disease – but not in men.
- 4. Men’s coronary artery plaque tends to distribute in clumps, whereas women’s tends to distribute more evenly throughout artery walls, thus lending credibility to cardiologists’ suspicion that “men explode, but women erode“. This tendency results in women’s diagnostic tests (designed to detect those large artery-blocking clumps in white, middle-aged men) frequently being misinterpreted as “normal”.
- 5. Women wait longer than men to go to a hospital Emergency Department when experiencing heart cardiac symptoms.
- 6. Average risk of being misdiagnosed in mid-heart attack for both men and women is about one in 50 – unless you’re a women under 55, in which case you are seven times more likely to be misdiagnosed compared to men.(1)
- 7. After a heart attack, women are less likely than men to receive standard treaments like beta blockers, ACE inhibitors and even aspirin – therapies known to improve survival. This contributes to a higher rate of complication after heart attacks in women, even after adjusting for age. See also: Fewer Lights/Sirens When a Woman Heart Patient is in the Ambulance.
- 8. Over 46% of women but only 22% of men heart attack survivors will be disabled with heart failure within six years.
- 9. Women are 2-3 times more likely to die following open heart bypass surgery. But younger women between the ages of 40-59 are four times more likely to die from bypass surgery than men of the same age.
- 10. Women with diabetes have more than double the risk of heart attack than women who are not diagnosed with diabetes. Diabetes doubles the risk of a second heart attack in women, but not in men. Diabetes affects many more women than men after the age of 45.
- 11. Women who are eligible candidates to receive life-saving clot-busting drugs in hospital are far less likely than our male counterparts to receive them.
- 12. The best course of treatment for a woman with heart disease has yet to be established, but women currently receive fewer cardiac procedures than men. Cardiologist Dr. Benjamin Lewis once told Healthline interviewers: “Women really have to almost earn their way into the healthcare system through an acute illness as opposed to men, who are more likely to be diagnosed before some catastrophe strikes.”
- 13. Women comprise less than 24% of participants in all heart-related research studies even though we make up 53% of heart patients. In fact, for generations, even the lab animals used in medical research have been male animals.
- 14. In 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.” I can’t decide, by the way, what part of that announcement upset me more at the time: its conclusion, or the fact that this was the first time ever in the 92-year history of the AHA that a statement on women and heart attacks had been released!
Sources: WomenHeart, Women’s Heart Foundation, Mayo Clinic , Heart and Stroke Foundation
(1) Pope JH, Aufderheide TP, Ruthazer R, et al. Missed diagnoses of acute cardiac ischemia in the emergency department. N Engl J Med. 2000;342:1163-1170.
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NOTE FROM CAROLYN: I wrote much more about the cardiology gender gap in Chapter 3 of my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use their code HTWN to save 30% off the list price).
♥
See also:
Finally. An Official Scientific Statement on Heart Attacks in Women
Heart Sisters 
I haven’t even read past the first paragraph yet, Carolyn — I’m laughing too hard!
Also, what planet does this person live on, where doctors have a laser-like focus on women’s heart health? Because that’s a planet I’d really like to live on, and so would millions of other women.
Still laughing,
Laura
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Yeah, I’d be happy to just go VISIT that planet of his . . . 😉
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“42% of women die within the first year following a heart attack “
Is it the case that if you make it past the first year your chances improve ? In other words is the first year the mostly likely for complications and another event or just that 38% don’t live past 12 months.
My wife recently had a heart attack and all the doctors are telling her everything is fine ….
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Hello Jim – the stats are alarming, no doubt about it. Complications may occur immediately following the heart attack (the acute phase), or may need time to develop (a chronic problem).
All of our treatment goals are to limit the extent of damage to the heart muscle, reduce the heart’s workload, and prevent or treat complications. But the likelihood of subsequent complications often depends on the size and severity of the cardiac event (plus patient’s age, overall health, other contributing diagnoses and lifestyle factors like smoking, obesity or inactivity). Based on these factors, doctors can then assess their patients as being low or high risk.
Sounds like your wife has, luckily, been assessed as low risk for future complications. She should discuss this in more detail at her next follow-up cardiologist’s appointment, and she must now pay close attention to ALL recommendations for heart-healthy lifestyle changes.
Doctors can patch us up, stent us, bypass us, zap our electrical currents, and order powerful cardiac drugs for us – but none of that can address the reasons we had the heart attack in the first place. But lifestyle improvements can.
Cheers,
C.
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Thank you for the valuable post. This knowledge will help in creating awareness about heart attacks occurrences possibility.
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Thank’s For Your Info About the reasons to be glad having a heart attack ..I have enjoyed visiting this site today. I really like your site. I’ll bookmark the pages.
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Do the women in this and other groups think differently about women who have had aortic valves replaced as not quite one of them?
I was told by the doctors that I would be back to myself as if nothing happened. What a bunch of foooy! It’s been a little over a year and I’m not 100% yet. I finally realized I am not going to be either. I am still treated like all women with a heart problem which is OK with me because my heart is different and feels different.
Also, I was not sent home with a diet for the heart either.
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I can see why you might sometimes feel this way! But anybody who undergoes aortic valve replacement, which is very serious cardiac surgery, certainly qualifies as being “one of us”. And although your doctors were likely just trying to reassure you, it’s clear that they’ve never been heart patients themselves, because nobody who has survived any cardiac event would dream of making such a casual, dismissive “as if nothing happened” remark.
Since my own heart attack, I have also observed what I call an unspoken “Hierarchy of Heart Disease” in which, for example, a heart transplant patient ‘trumps’ a bypass patient, a quadruple bypass ‘trumps’ a double bypass, four stents ‘trump’ a single stent implant, a heart attack survivor ‘trumps’ an afib patient who’s never experienced an M.I., etc. etc.
I’ve been guilty of this myself, often mentioning the phrase “heart attack” here as if every heart patient has survived one. There are many different forms of heart disease, and I believe that there is no such thing as a “minor” cardiac event.
Thanks so much for your comments.
Cheers,
C.
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Great Post thanks for sharing – we need to try and educate as many women as possible.
I am a nurse practitioner and have taken care of hundreds of women who have had heart attacks. and I can tell you from personal experience – women DO take longer to get to the hospital, it takes longer for physicians to recognize a heart attack in women and longer to start the appropriate treatment because many women do not present with the typical symptom of “crushing chest pain”.
We need to empower women to know the signs and symptoms to watch out for and get to the hospital as quickly as possible.
Carolyn
http://www.heart-strong.com
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You are so right, Carolyn! Awareness and willingness to seek help are so important. You may have seen the American Journal of Critical Care issue that published an Oregon study last year looking at women in mid-heart attack. They identified six distinct kinds of “treatment seeking delay” behaviours in women.
But it’s not only important for women to seek immediate medical help, their diagnosis is only as good as the current testing technology and the diagnostic skills of the E.R. staff in hospital. For example, I presented with textbook heart attack symptoms (crushing chest pain, pain radiating down my left arm) yet was sent home from the E.R. within five hours with an acid reflux misdiagnosis after my cardiac enzymes and EKG came back “normal”.
And I am not alone! At Mayo Clinic, I met dozens of women like me who had been sent home from the E.R. in mid-heart attack. One woman told me that she’d been sent home three times (smarter than me, she kept going back – essentially insisting: “I don’t care what you say – I know that something is seriously wrong with me!”) On her third visit to the E.R., the doc suggested she might consider taking anti-depressants. On her fourth visit, she had double bypass surgery.
Keep up the good work!
cheers,
C.
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When I went into the emergency room on February 18th, 2010 with the worst chest pain I have ever known, the ER doctor said, “You probably just pulled a muscle.”
When the blood work came back, he came back into my room and said, “there will be a cardiologist coming in to talk to you” and turned around and walked out. I felt like he could have cared less about me. The thing is I had already had 5 stents placed, so he knew I was a heart patient and at risk.
I will say, my cardiologist is wonderful and treats me with a lot of respect and truly cares. However, my electrical cardiologist does concern me. He is arrogant and I’m not sure he really cares. He told me I have A-Fib, but my heart rate stays under 60 all the time, even with exercise. I’m going to go to another one for a second opinion.
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Good luck, Sandy. As my friend Lynnie says about her doctors, “You don’t have to go camping with them!” Finding a caring, respectful physician is a wonderful bonus, but in my experience not necessarily commonplace. I’m happy to say that this appears to be changing in medical schools. It used to be that if you were in the 97th percentile of med school applicants, you’d be a shoe-in. Now, however, we know that the brainiacs may not make the best doctors, so schools are looking at wider criteria like volunteer experience, community involvement, PERSONALITY….
cheers,
C.
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This list is pretty disturbing when you see these facts all listed like this.
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Hi
I had my heart stented last June 9th.(Just CELEBRATED my RE-BIRTH!). The Dr. I was “given” was a male.
I knew nothing, he never gave me a diet to follow, never gave me an exercise routine to follow. HOWEVER I heard male patients in his office talk about the diets they had, the cardiac rehab gym they had been sent to, the tests they were given in the office.
I was only being sent for blood work, nothing else. I finally asked about the gym I was hearing about, and discovered my healh plan covered an 8-week recovery rehab. Imagine that, BIG secret, but only for me!
My General Dr. told me my diet was good, he also gave me the name of a book to get concerning Nutrition and your Heart. After a couple of visits (knowing nothing about stents, heart issues), I realized that when I told him my concerns, little pains, flutters, he would look at my paperwork, then look at me and say, “Nothing to worry about, ALL YOUR NUMBERS LOOK GOOD”. That bothered me SO MUCH. I am NOT a NUMBER, I AM A WOMAN !!! (You NEED to LISTEN and HEAR me please).
That is when I decided to learn ALL I could to make an intelligent decision about getting a NEW Dr. I did much research in the past year, I now have one of The BEST rated DR’s in RI and MA, AND my Dr is a WOMAN.
When I talk to her, she hears and listens. I am not a NUMBER, I am a WOMAN, I was given a Diet my very first vist, even though she thought I ate very healthy, she asked that I omit chicken (I ate once or twice a week). Sent me for tests, and corrected a few things. I have NEVER felt better! I now have peace of mind, when you have that – your stress levels go down, so your Odds of making it are so much better!
We WOMEN have to watch out for each other, your articles have helped me so much. Because of these articles “I never feel alone”.
This year I have felt so good, besides working my full time job (that I never took any time off), I make crystal jewelry, designed and published my website! I am very proud of that. I now have an online business along with my full career as a Data Engineer.
~ Bright Blessings~
Lady Selene
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Hi Selene and Happy Anniversary to you! I’m so glad that you have found a cardiologist who is a good listener – a wonderful quality in any doctor. I’m curious, however, about why she suggested that you cut out chicken in your diet?
Congrats on your new business venture – hope it goes very well.
cheers,
C.
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Hi Carolyn, Thank you very much! The Dr. is a firm believer that her patients are either Pescatarian or Vegeterian, she said she has seen much better results with no meat, and as little processed food as possible. I have been eating fresh fruits, veggies, beans, egg whites, and some sea food once in a while. I feel great! I have also read a book (advised by my general Dr. last year) Reversing Heart Disease. It also promotes a Vegetarian way of Life. I have no problem at all with this, I had been a Vegetarian for years (I have never really been a meat person). I have also been reading a lot about how we ladies process carb’s much differently than men, so staying away from all the processed food also makes a lot of sense.
~Lady Selene~
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