Emergency physician Dr. Pat Croskerry tells the story of the day he misdiagnosed a patient who was experiencing unstable angina – chest pain caused by coronary artery disease, and often a warning sign of oncoming heart attack. But this is what he’d said before sending that patient home:
“I’m not at all worried about your chest pain. You probably overexerted yourself and strained a muscle. My suspicion that this is coming from your heart is about zero.”
I sometimes think that, during the years I’ve been writing about women’s heart disease research, diagnostics, treatment or outcomes, I’ve heard it all when it comes to women being under-diagnosed and under-treated (yes, sometimes under-treated even when appropriately diagnosed!) I thought I was unshockable by now. But a study published in the journal, Women’s Health Issues (WHI) was indeed a shocker.(1) . Continue reading “Fewer lights/sirens when a woman heart patient is in the ambulance”→
Imagine the reaction from Emergency Department staff to the woman I met at my Mayo Clinic training, the one who had been sent home from Emergency three days in a row despite her complaints of increasingly distressing cardiac symptoms. Each time she arrived there, she clearly declared the following to the Emergency physician, who continued to repeatedly dismiss her concerns:
“I don’t care what you say. SOMETHING is wrong with me!”
What a royal pain in the ass, staff may have muttered about her, sotto voce.
On her third visit, the physician recommended anti-anxiety medications. But on the fourth visit, on that fourth day, she was taken directly from the E.R. to the O.R. to undergo emergency coronary bypass surgery. Continue reading “Is ‘being nice’ hurting women?”→
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)