Gaps persist in knowledge about women and heart disease

Physicians are being reminded of women's high rate of heart disease and some possible gender differences in symptoms and diagnosis.

By Susan J. Landers, AMNews staff. April 16, 2001.

Washington -- The saga of Julia Carson's quest for relief from her chest discomfort could serve as a case study in what can go wrong in diagnosing and treating heart disease in women.

First, her primary care physician attributed her complaints that something was wrong with her heart to the stress of a recent election campaign -- Carson, a Democrat, is a U.S. representative from Indiana. Then she underwent a battery of tests -- but none on her heart.

When the pain got too bad, Carson called the emergency department of her local hospital and said she would be coming in. But, rather than head straight over, she detoured to keep a previous appointment.

Not only did Carson wind up having a double-bypass operation at the hospital, but she also had to replace her front door, which had been removed by emergency personnel who feared she had been too ill to leave her home.

Although this example may seem extreme, much of what Carson experienced is fairly common. Too often, physicians miss properly diagnosing heart disease or heart attacks in women, attributing symptoms to hot flashes or indigestion. And just as frequently, women decide to finish cooking dinner or wait until someone can drive them to the hospital rather than calling 911 right away.

Women are thought to be at less risk of heart disease and heart attacks than men. However, cardiovascular disease, both coronary heart disease and stroke, are the leading causes of death in women in this country, according to the American Heart Assn. Both claim more female lives than the next 16 causes of death combined, including all forms of cancer, chronic lung disease, pneumonia, diabetes, unintentional injuries and AIDS. [...]