Women & heart disease

by Carolyn Thomas   ♥  @HeartSisters

“I had no clue that this was such an issue, or how ‘at risk’ I am for heart disease.  Thank you sincerely for your presentation, and for making a difference in women’s lives.”

Five months after my heart attack, I attended the WomenHeart Science & Leadership Symposium for Women with Heart Disease (the first Canadian ever invited to attend this annual community educator training!) at the world-famous Mayo Clinic in Rochester, Minnesota.  Mayo cardiologists taught us more than I ever imagined was possible to absorb about women and heart disease.*

What I learned at Mayo Clinic was shocking. 

In a nutshell, as my Mayo heart sister Laura Haywood-Cory, who at age 40 survived a heart attack caused by Spontaneous Coronary Artery Dissection, likes to say:

“Sucks to be female. Better luck next life!”

-most cardiac research over the past four decades has been done either exclusively on male subjects, or with fewer than 20%  female subjects (and all early cardiac studies on animals have used only male lab animals!)

-women are under-diagnosed and under-treated compared to male heart patients (UPDATE: see the 2016 Scientific Statement on Women and Heart Attacks from the American Heart Association, which confirms what we learned at Mayo back in 2008. This was the first such scientific statement from the AHA in their 92-year history).

-cardiac diagnostic tests may not be as accurate for women as for men

-women experience more delays in symptom recognition and treatment

-heart disease kills six times more women worldwide than breast cancer – in fact, heart disease kills more women than all cancers combined

-heart disease kills more women than men every year

-women heart patients are more frequently misdiagnosed than men

-even when accurately diagnosed, women are less likely than men to receive proven guideline treatments (angiography, angioplasty, beta blocker or statin drugs – and even aspirin!)

 See also: Cardiac Gender Bias: We Need Less TALK and More WALK

What we also learned at Mayo Clinic is that of the 45 women attending our Symposium – all of us heart disease survivors – about one-third had been initially sent home from Emergency with misdiagnoses ranging from indigestion to anxiety or menopause. Sadly, misdiagnosis in women is tragically common; a study reported in The New England Journal of Medicine revealed that women under the age of 55 are SEVEN TIMES more likely to be misdiagnosed and sent home from the E.R. in mid-heart attack compared to their male counterparts.(1)

I too had been initially sent home from Emergency with an acid reflux misdiagnosis, despite presenting with textbook heart attack symptoms like crushing central chest pain, nausea, sweating, and pain radiating down my left arm.  

For two weeks, I suffered increasingly worsening symptoms – but at least I knew it wasn’t my heart, because a man with the letters M.D. after his name had told me so quite clearly. I was in deep, deep denial even as my symptoms became unbearable. (Read more about the rest of  my story).

Now, whenever I speak to other women about heart disease, I encourage them to:

-empower yourself by not minimizing your health concerns and symptoms

-assume primary responsibility for your health

-become your own best health advocate

-know the warning signs of a heart attack, and have an action plan

-know your personal risk factors and take immediate steps to address them starting today – especially important if you have ever been diagnosed with pregnancy complications, which we now know are strongly linked to heart disease

-find out more about other gender differences in women’s overall health care.

-tell other women you care about what YOU have learned about heart health

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* Do you need a jargon-free, patient-friendly glossary to help you translate confusing cardiology phrases and terminology?

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NOTE FROM CAROLYN:  I wrote much more about these and other topics in my book A Woman’s Guide to Living with Heart Disease (Johns Hopkins University Press, 2017). You can ask for this book at your local bookshop, or order it online (paperback, hardcover or e-book) at Amazon.  If you order it directly from Johns Hopkins University Press (use their code HTWN) you can save 30% off the list price.

Watch this video!

“A Typical Heart” – a remarkable Canadian documentary film (about 22 minutes in length) created to raise awareness of the deadly disparity in research, diagnosis, treatment and outcomes between male and female heart patients.

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(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.