by Carolyn Thomas ♥ @HeartSisters
The irreverent Laura Haywood-Cory of North Carolina is, like me, a heart attack survivor and, also like me, a graduate of Mayo Clinic’s annual WomenHeart Science & Leadership Symposium for Women With Heart Disease in Rochester, Minnesota (where she’s also attended the Mayo Clinic Social Media Summit, too!)
Her own dramatic heart story is that of a terrifying condition usually seen in young, healthy women with few if any known cardiac risk factors: Spontaneous Coronary Artery Dissection or SCAD. I’m happy to say she has been making a heroic effort to beat this sucker into the ground; after surviving her heart attack at age 40, Laura completed the Chapel Hill Ramblin’ Rose Triathlon. But it’s her unique take on a surprisingly frequent response to women’s heart disease that I want to share with you today. Laura wrote: ♥
“At almost every public event where I’m volunteering with WomenHeart, someone with XY chromosomes will come up to me and say some variation on:
“Where’s the men’s group?”
Then they get a smug look on their faces as if they’ve just scored a major “Gotcha!” and they scuttle away, oh-so-pleased with themselves for their clever little bons mots.
“Oh, honey!” I want to say to them: “It’s ALWAYS about the men.”
“Almost 75% of the research on heart disease is done on men; women comprise only 27% of heart disease research subjects in North America.
“Women who present with the exact same symptoms as men are often told that it’s our gall bladder, it’s anxiety, it’s stress, it’s acid reflux – anything but what it actually is: our hearts.
“A Cardiovascular Research Foundation study(1) was done at Cornell University where med students were given imaginary case histories for two patients:
- a 48-year-old male
- a 58-year-old female
“Aside from the age, everything else was identical. The two patients had all the risk factors for a heart attack, including the stress of having just been turned down for a job promotion.
“The majority of the students referred the male patient to a cardiologist; the majority referred the female to a psychologist.
“Read that again: the man gets sent to a cardiologist. The little woman gets told that it’s all in her head.
“Women with heart attack symptoms are less likely than men to receive life-saving clot-busting drugs, less likely to even receive simple treatments like an aspirin or a nitro patch.
“Women survivors are less likely to be referred for cardiac rehab.
“Women have a 28% increased risk of dying compared to men within the first year after a heart attack (perhaps because of the fact that we’re less likely to get adequate treatment, as noted).
“It’s not “us versus them” in that we women heart patients and advocates are taking something away from male heart patients. What we’re striving for is EQUAL access to correct diagnoses and treatment.
“In order to do that, we have to address the current inequalities – you can’t change the fact that because you’re male, you’re automatically going to be treated differently if you complain of chest pain than a woman is going to be.
“In general, men don’t have to fight to be believed if they show up in a doctor’s office and say that they think they’re having a heart attack.
“We do. We have to. Every single day.
“That’s part of WomenHeart’s mission – to educate women (and men) about heart disease, our #1 killer, to educate the medical community, and to advocate for equal access and treatment.
“We don’t want to take away the men’s piece of the pie (access to accurate diagnosis and correct treatment); we want to ensure that everyone has pie.
“And everyone wants pie, right?”
♥ The American Heart Association finally released its first ever scientific statement on women’s heart attacks in its 92-year history, 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.”
♥ Female heart patients are more likely to be unexpectedly re-admitted to hospital with heart failure compared to men (22.3% of men vs. 29.6% of women). “We don’t know a lot about re-admissions,” said lead author Dr. C. S. Kwok. American Journal of Cardiology. ♥ Q: Maybe it’s about time we DID know more about why female heart patients are being unexpectedly re-admitted after hospital discharge?
♥ Fewer Women Would Die of Heart Attacks if Given Same Treatments as Men. After accounting for the expected number of deaths seen in the average population, the researchers studied 180,000 people over 10 years and found that women had an excess mortality of up to three times higher than men’s in the year after having a heart attack. Journal of the American Heart Association.
♥ Women and Heart Disease: New Data Reaffirms Lack of Awareness By Women and Physicians. While 74% of women reported having at least one risk factor for heart disease, just 16% were told by their doctor that they were at risk. Journal of the American College of Cardiology.
(1) Cardiovascular Research Foundation (2008, October 12). Signs Of Heart Disease Are Attributed To Stress More Frequently In Women Than Men.
Q: Why do you think, as Laura says, that it’s “always been about the men?”
See other posts written here by or about Laura Haywood-Cory:
All the SCAD ladies, put your hands up!” (from The Wall Street Journal’s feature on Laura and Katherine Leon‘s success in convincing Mayo Clinic cardiologists to undertake SCAD research
Be your own hero during a heart attack
NOTE FROM CAROLYN: I wrote much more about adjusting to a new cardiac diagnosis in 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).
8 thoughts on “But what about the men?”
I have been told twice in my life that IT was all in my head. The first it was eventually major surgery for endometriosis❗️ The second time, told IT was in my head not so long ago, ended in a diagnosis of proximal atrial fibrillation by a female cardiologist.
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Sheeesh! You’re like the poster child for “all in your head” misdiagnoses, Em! Hope you are doing well now…
Regarding “The majority of the students referred the male patient to a cardiologist; the majority referred the female to a psychologist.” –– Speaking as a psychologist and heart attack survivor who has seen more than ten cardiologists– since 80% of heart attacks may be preventable with lifestyle changes, the psychologist might be able to help more than the cardiologist, or at least many of the ones I have seen.
On the other hand, speaking as a psychologist (again!), those Cornell medical students should be referred to psychologist to get their heads on straight about women and heart disease.
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Hi Dr. Steve – thanks for weighing in here (as a psychologist!)
I once heard a cardiologist, when questioned about the frequency of post-MI depression in his patients, respond: “This is not my area of interest” just as if he didn’t grasp the bleedin’ obvious: that a heart patient who is depressed is unlikely to 1. take the cardiac meds being prescribed, or 2. exercise as directed, or 3. eat heart-healthy food, or 4. stop smoking, or 5. sleep well.
I think both you and I would likely prefer to see a good cardiologist FIRST for immediate treatment while in mid-heart attack, and then see our psychologists for ongoing emotional and mental support to be able to accomplish 1, 2, 3, 4, 5, etc….
Hi Carolyn… Yeah, I haven’t had much luck with cardiologists paying attention to psychological issues…. I have learned to avoid telling them the dream that predicted the heart problems so I don’t get an eye roll… On the other hand, the good doctor Jimenez-Lopez at Mayo actually listened to the story and the last time I was there he told the resident about it…
And yes, cardiologist first, psychologist and/or support network second….
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Thanks for reminding me of that dream. How encouraging that Mayo Clinic cardiologists are passing on your story to residents! I just found this interesting Mayo interview with your doc….
Yes, Mayo operates at a much different level. One of the Seven Wonders of the World.
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You are so right! When I returned after my first trip To Mayo Clinic in 2008, I remember saying to my family that, had I not seen this place with my own eyes, I would never have believed that such a place could exist on this earth…
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