Category: Diagnosing – and misdiagnosing

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

How women can have heart attacks without having any blocked arteries

~ Carolyn Thomas ~ 99 Comments

by Carolyn Thomas  ♥  @HeartSisters

Turns out that the kind of heart attack that I had (caused by a 95% blockage in the big left anterior descending coronary artery) – the so-called widowmaker heart attack – may actually be relatively uncommon  in women. You might guess that fact by its nickname.  It’s not, after all, called the “widower-maker”.

While cardiologists warn that heart disease can’t be divided into male and female forms, there are some surprising differences. Cardiologist Dr. Amir Lerman at the world famous Mayo Clinic in Rochester, Minnesota, told the Los Angeles Times recently:

“When it comes to acute heart attacks and sudden death from cardiac arrest, women have these kinds of events much more often without any obstructions in their coronary arteries.”

Instead, it appears that a significant portion of women suffer from another form of heart disease altogether. It affects not the superhighway coronary arteries but rather the smaller arteries, called microvessels. These tiny arteries deliver blood directly to the heart muscle.

Ironically, I can now boast two diagnoses for the price of one – first, the widowmaker heart attack caused by a fully occluded coronary artery back in 2008, and then, after several months of puzzling, ongoing cardiac symptoms – like chest pain, shortness of breath, and crushing fatigue – a second diagnosis of inoperable coronary microvascular disease. Continue reading “How women can have heart attacks without having any blocked arteries” →

Gender differences in heart attack treatment contribute to women’s higher death rates

~ Carolyn Thomas ~ 9 Comments

The alarming results of a study undertaken in France highlighted serious gender differences in cardiac treatment of men and women.  These shocking differences contribute to a higher death rate among women suffering a heart attack.

The French study(1) investigated more than 3,000 patients, 32% women, who had been treated for heart attacks over a two-year period.

Lead author Dr. Francois Schiele, Cardiology Chief at the University Hospital in Besancon, France, presented the results of the research at the American College of Cardiology’s 59th Annual Scientific Session in Atlanta last month. Dr. Schiele’s team found that, on average, the women studied:

Inside your heart – as captured by National Geographic

~ Carolyn Thomas ~ 4 Comments

Here’s how your heart looks during a coronary angiography procedure. The white/yellow blood vessels are bringing oxygenated blood to the working muscles of the heart.  (See link below to the whole slide show).

Coronary angiography (also called cardiac catheterization) is sometimes referred to as the ‘gold standard’ of diagnostics for heart patients. The procedure involves threading a tiny catheter through an artery in the wrist or groin and pushing it up, up, up right into the beating heart. It’s considered to be an invasive procedure, but not surgical. Patients are sedated, but usually awake throughout.

The catheter is guided through the artery with the aid of a special x-ray machine. Contrast material (dye) is injected through the catheter and x-ray movies are created as the contrast material moves through the heart’s chambers, valves and major vessels.

The interventional cardiologists in the ‘cath lab’ then watch your beating heart up on the monitor, where they can spot any coronary arteries that are blocked or narrowed, and evaluate your heart function. If significant blockages are seen, further procedures like balloon angioplasty, stent implants or coronary artery bypass graft (CABG) – commonly known as bypass surgery – may be attempted to restore blood flow to the threatened heart muscle.

I’ve undergone two of these invasive cardiac procedures – the first an emergency catheterization and stent implant when I was hospitalized for a heart attack, the second 15 months later to investigate ongoing cardiac symptoms. And I can tell you that it is freakishly fascinating to lie on the cath lab table, sedated yet very awake, and watch your own beating heart on the overhead monitor.   Continue reading “Inside your heart – as captured by National Geographic” →

“Take two aspirins and Tweet me in the morning!”

~ Carolyn Thomas ~ 5 Comments

You woke up feeling sick today. Your throat is scratchy, your head is imploding, and you just don’t think you can even leave your bed. You might have the flu. What do you do?

If you live in the Brooklyn borough of New York City, you stagger over to your computer and log in to your doctor’s office website at Hello Health to schedule an online Instant Messaging visit. Very soon, during that IM chat, your regular doctor asks some questions and confirms that it’s a virus. She tells you there’s nothing to worry about just yet, to drink plenty of fluids, and take Tylenol™ for the fever. Oh, and she’ll contact you tomorrow.

Feeling better now?  In the olden days before the Hello Health concept, the traditional time spent dragging your sorry flu-addled self out of bed and all the way downtown to your doctor’s office, including two aching and feverish hours spent shivering in the waiting room infecting other patients, would have been about four hours of your life that you’d never get back.

But time spent with your Hello Health doctor’s visit?  Less than one hour, without even brushing your teeth, changing out of your sweaty jammies, or leaving home. 

Indeed, across our health care system, from large hospital networks to patient support groups, new media tools like blogs, IM platforms, video chat, and social networks like Twitter and Facebook are re-engineering the way doctors and patients interact.   Continue reading ““Take two aspirins and Tweet me in the morning!”” →