Category: Diagnosing – and misdiagnosing

– posts here focus on how difficult it often is to get an accurate heart disease diagnosis in women

Is coronary microvascular disease serious? Is the Pope Catholic?

~ Carolyn Thomas ~ 26 Comments

by Carolyn Thomas  ♥  @HeartSisters

It’s time for physicians to stop telling patients that a diagnosis of coronary microvascular disease (MVD) is no big deal. Or alternatively, to accept that the diagnosis is real in the first place. As one of my blog readers learned to her horror, this awareness is not yet universal. When she asked her own physician, for example, if her debilitating cardiac symptoms might be due to coronary microvascular disease, he replied: “I don’t believe in microvascular disease!” – as if they’d been discussing the damned Tooth Fairy.

But here’s how Dr. Stacey Rosen, a cardiologist and spokeswoman for the American Heart Association’s Go Red For Women campaign, answered a question about microvascular disease in the New York Times recently:

Q: “I have been diagnosed with microvascular heart disease, which I was told mostly affects women and is not considered serious in and of itself. How long can it exist before it turns into serious heart disease?”

A:  “MVD can lead to heart attacks, heart failure and death. It’s serious.” Continue reading “Is coronary microvascular disease serious? Is the Pope Catholic?” →

Dear Carolyn: “I had both acid reflux and a heart attack at the same time!”

~ Carolyn Thomas ~ 15 Comments

by Carolyn Thomas  ♥  @HeartSisters

As I’ve repeatedly insisted, my Heart Sisters blog readers are the smartest, kindest, sharpest and best-looking readers out there in the blogosphere. . .  Today starts a series of Dear Carolyn posts starring my readers, each of whom has contacted me over the years to share, in her own words, the unique story of how she became a heart patient. Most of these, as you’ll discover if you keep up with this series, involve an “aha!” moment, or a plot twist that I didn’t see coming, or a lesson that just strikes me as downright useful for other women to know. And if you too have a personal heart story you think needs to be shared with the world (or at least the part of our world reading Heart Sisters each week), please share yours by contacting me here.

Today’s tale focuses on one of my favourite themes in women’s heart health: it’s possible to have both acid reflux (or any other chronic condition) AND a heart condition all at the same time. It’s from Debbie Orth, who lives near Cleveland, Ohio. (That’s Debbie in olive green at the centre of the photo above, having fun on a family cruise while celebrating her parents’ 50th wedding anniversary, just seven months post-heart attack!) Continue reading “Dear Carolyn: “I had both acid reflux and a heart attack at the same time!”” →

How implicit bias in medicine hurts women and minorities

~ Carolyn Thomas ~ 8 Comments

by Carolyn Thomas  ♥  @HeartSisters

It’s discouraging. I’ve read (and written) far too much about how the gender gap in cardiology has resulted in women heart patients being at higher risk of being both under-diagnosed compared to our male counterparts, and then under-treated even when we’re appropriately diagnosed (here,   here   and  here, for example). Studies even suggest that when physicians review case studies in which patients present with significant cardiac symptoms as well as a recent emotionally upsetting event (identical except for the patients’ male or female names), the doctors are significantly more likely to determine that a man’s symptoms are heart-related, but a woman’s symptoms are just due to the emotional upset.(1)

But what’s been missing in this acknowledged gender gap seems to be the most important part: why is this happening, and what can we do to actually address it? Continue reading “How implicit bias in medicine hurts women and minorities” →

The shock – and ironic relief – of hearing a serious diagnosis

~ Carolyn Thomas ~ 28 Comments

by Carolyn Thomas  ♥  @HeartSisters

I vaguely recall my gurney being wheeled very quickly down a wide hospital corridor after I heard the words “heart attack” from the cardiologist who had been called to the E.R.  I stared up at the ceiling lights flicking by overhead, feeling freakishly calm, considering. Here’s what I recall thinking in my strangely calm state: when I’d first come into this same E.R. two weeks earlier, terrified that my symptoms of chest pain, nausea, sweating and pain down my left arm might be due to a heart attack, I had been right!

The symptoms had never been because I was “in the right demographic for acid reflux” (despite what the Emergency physician who’d sent me home that first day had confidently pronounced). But now, after two weeks of popping Gaviscon like candy for these increasingly horrific symptoms, I felt relieved. I knew that all of the people around me now would know how to take care of me. The shock of hearing my new (correct) diagnosis of heart attack was subsumed in that moment by a wave of profound relief. Continue reading “The shock – and ironic relief – of hearing a serious diagnosis” →