Why won’t doctors believe women?

by Carolyn Thomas     @HeartSisters    March 24, 2019

A woman in one of my Heart-Smart Women presentation audiences told me about a conversation she overheard in our local Emergency Department, in which the physician said to the (male) patient in the bed next to hers:

“All of your cardiac tests came back ‘normal’, but we’re going to admit you for observation just to make sure it isn’t your heart.”

That story tells us that (unlike your average woman – i.e. me! – with cardiac symptoms alarming enough to propel her to seek emergency care, but unlucky enough to have tests that look “normal”), a man who shows up with both cardiac symptoms and “normal” test results does not need to fight to be believed. Continue reading “Why won’t doctors believe women?”

The dilemma of the death certificate

by Carolyn Thomas     @HeartSisters    February 3, 2019
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In a good old-fashioned murder mystery, we know that the plot starts to heat up when the dead body is discovered and the cause of death determined. But in real life, most of us will not die quite so dramatically.
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If we live with one or more chronic illnesses, in fact, the name of at least one of those diagnoses will probably be listed on our official death certificates someday. (We could also get run over by a bus long before then, but let’s face it, chronic diseases cause 70% of deaths worldwide).
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It struck me recently that, had I died during what doctors call my widowmaker heart attack in 2008, the official cause of death would have likely read “myocardial infarction”. But that would have been wrong. The actual cause of my death would have been that I was misdiagnosed with acid reflux and sent home from the Emergency Department.
Continue reading “The dilemma of the death certificate”

The medical apology: have you ever received one?

by Carolyn Thomas    @HeartSisters     August 26, 2018

I’ve been invited to participate in an academic study on an interesting concept: the medical apology. My first reaction was to decline the invitation, explaining that never once have I had a healthcare professional apologize to me when something went wrong. And I’ve had a few things go very, very wrong.

I could have used an apology at age 16, for example, when the infirmary nurse at my convent boarding school repeatedly refused my pleas to call the local doctor for my severe appendicitis symptoms, instead blaming them first on the flu, the next day on my period, and the third day on exam anxiety. I was finally hospitalized with a ruptured appendix and near-fatal peritonitis that required a month-long hospital stay. A little “I’m sorry” would have been nice. . .

But I’m thinking that some of you might have some interesting personal experiences about receiving a medical apology to share on this subject. If you’d like to get involved, here’s how to contact the researchers: Continue reading “The medical apology: have you ever received one?”

Women’s heart disease: is it underdiagnosed, or misdiagnosed?

by Carolyn Thomas    @HeartSisters

Do you know the difference between a medical condition that’s underdiagnosed, and one that’s misdiagnosed? I thought you’d never ask. . .  Underdiagnosis is a failure to recognize or correctly diagnose a disease or condition, especially in a significant proportion of patients, as in: “Heart disease in women is still being underdiagnosed compared to our male counterparts.”(1) But misdiagnosis is an incorrect, partial or delayed diagnosis of one individual’s illness or other medical problem, as in: “I left the Emergency Department with a misdiagnosis of acid reflux despite my textbook heart attack symptoms of central chest pain, nausea, sweating and pain down my left arm.”

The trouble is this: the more that misdiagnosis happens to individual women, one after another, the more likely we are to continue seeing underdiagnosis of women heart patients as a whole. Thank you to these heart patients who shared their own experiences of surviving a misdiagnosis: Continue reading “Women’s heart disease: is it underdiagnosed, or misdiagnosed?”

Mandatory reporting of diagnostic errors: “Not the right time?”

by Carolyn Thomas    @HeartSisters

I can’t be 100% certain, but I’m betting my next squirt of nitro spray that the Emergency Department physician who misdiagnosed me with acid reflux and sent me home despite my textbook heart attack symptoms (central chest pain, nausea, sweating and pain down my left arm) did NOT voluntarily report his diagnostic error to his supervisor or to anybody else after I was correctly diagnosed much later by a different emergency doc. Continue reading “Mandatory reporting of diagnostic errors: “Not the right time?””

“It’s not your heart. It’s just _____” (insert misdiagnosis)

by Carolyn Thomas    @HeartSisters

It’s fair to say that you would not be reading these words had my heart attack not been misdiagnosed with a cheerful “You are in the right demographic for acid reflux!”  Had I been correctly diagnosed, admitted and appropriately treated during that first trip to the Emergency Department, I would likely never have started this blog in 2009. Nor would I be still writing years later about female heart patients being misdiagnosed in mid-heart attack.

We know that women continue to be under-diagnosed – and then under-treated even when appropriately diagnosed – compared to men presenting with cardiac symptoms.  In fact, as reported in the New England Journal of Medicine, female heart patients in their 50s and younger are seven times more likely to be misdiagnosed than our male counterparts.(1)

You know your body. You KNOW when something is just not right. Even if, like the following women, you too are sent home, do not hesitate to return to Emergency or to your physician if symptoms worsen.

Here’s my latest round of true tales from women whose cardiovascular disease is still being missed.    Continue reading ““It’s not your heart. It’s just _____” (insert misdiagnosis)”