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)
You know your body. You KNOW when something is just not right. Even if, like the following women, you too are sent home, do not hesitate to return to Emergency or to your physician if symptoms worsen.
Here’s my latest round of true tales from women whose cardiovascular disease is still being missed.
♥ “Had my first heart attack at age 39, sitting at my desk at work. Six years later, I was told by ER doctors that my new symptoms were now due to Spontaneous Coronary Artery Dissection, then told, no, it’s a Coronary Artery Spasm. Went home with chest pains while at rest, then told that because they were happening at rest, it couldn’t possibly be angina. Then told it was esophageal spasm, then told it must be anxiety as my pain happened any time any place. I went back to my cardiologist apologetically saying ‘I’m sorry to bother you again, but the symptoms of chest pains at rest, pain down left shoulder and into my jaw are exactly like just before my first heart attack six years ago.’ I was told it’s nothing to do with your heart, go and see a counselor as it’s just anxiety. I left his clinic not anxious, but very angry and feeling very stupid. His parting words were, ‘You are not going to have a heart attack!’ Guess what happened then?” (STEMI heart attack, age 45).
♥ “A cardiologist actually told me: ‘I can guarantee 100% this is not your heart. If you get the same pain again, do NOT go back to the ER – you’ll be wasting everyone’s time.’ Before this, I had been told my symptoms were likely: esophageal, indigestion, heartburn, anxiety, attention-seeking, mental illness, hyperventilation, bronchitis, blood clot on lung, an unknown virus, anything but my heart…” (Prinzmetal’s variant angina)
♥ “After complaining of a racing heart – starts up for no apparent reason – I was sent home from the ER with Valium! Made me sleepy, but no effect on the heart symptoms. After several visits to my family physician, I finally got a referral to a cardiologist. Three days in the hospital, multiple tests – finally correctly diagnosed.” (Mitral valve prolapse).
♥ “I had gone to the doctor about six months before my heart attack with severe indigestion. It was like nothing I had ever experienced before. I felt like there was a rock in my stomach and nothing would move. After thousands of dollars in tests, my doctor declared that she could not find anything wrong, and that I should go home and eat more fiber. Six months later, I had a heart attack, then five days later collapsed on the street. (Myocardial infarction, Cardiac arrest).
“Are you sure you’re eating enough?”
“Get some more sleep.”
“You’re too young!”
Thank you to all of my heart sisters who shared these real life experiences.
You know your body. You KNOW when something is just not right.
Even if you are sent home, do not hesitate to return to Emergency or to your physician if symptoms worsen.
NOTE FROM CAROLYN: I wrote much more about identifying cardiac symptoms in Chapter 1 of my book, “A Woman’s Guide to Living with Heart Disease”. You can ask for it at your local bookshop (my preference!) or order it online (paperback, hardcover or e-book) at Amazon, or order it directly from my publisher, Johns Hopkins University Press (use the JHUP code HTWN to save 20% off the list price).
NEWS UPDATE: January 25, 2016 ~ After 92 years, the American Heart Association released its first ever scientific statement on women’s heart attacks, confirming “compared to men, women tend to be under-treated“, 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.”
Q: Have you ever been told “It’s not your heart” – before being finally correctly diagnosed?
- Hysterical female? Just anxious? Or heart attack?
- Misdiagnosis: is it what doctors think, or HOW they think?
- Misdiagnosis: the perils of “unwarranted certainty”
- Seven ways to misdiagnose a heart attack
- Stupid things that doctors say to heart patients
- Cardiac gender bias: we need less TALK and more WALK
- Unconscious bias: why women don’t get the same care men do
- When you fear being labelled a “difficult” patient
- The sad reality of women’s heart disease hits home
- How can we get heart patients past the E.R. gatekeepers?
- How does it really feel to have a heart attack? Women survivors answer that question