Saturday, December 15, 2012

Women and Heart Disease

My grandmother was in the hospital two weeks ago due to a variety of health concerns that had left her on the verge of collapse.  She’s okay now (thanks to everyone who has been supportive through this!), but my family learned from her doctors that she has likely suffered a minor heart attack sometime in the past weeks.

We were shocked to hear this.  Heart attack?  There had been no signs-- no chest tightening, no irregular heartbeat, no arm pain, nothing.  

That is when the doctor informed us that women actually experience different heart attack symptoms than men.  A heart attack in a man presents itself in the ways enumerated above.  Women, however, are more likely to experience shortness of breath, extreme fatigue, nausea, vomiting, and dizziness as symptoms of their heart attacks.  My grandma had experienced several of these symptoms recently, but had no idea of their deeper significance.  And she's not alone-- heart attacks in women are often misdiagnosed and it is not unusual for a woman to be sent home when presenting her symptoms.  The symptoms we are taught to look for often do not appear in women at all.  In fact, 43% of women do not ever experience the primary tell-tale sign, chest pains, during a heart attack, even though many emergency room doctors still consider this the primary symptom.

This has huge implications for women's health.  Without knowing something is wrong (assuming she survives an initital undiagnosed heart attack), a woman will delay crucial treatment and lifestyle changes necessary to prevent her heart disease from progressing.  As heart disease is the number one killer of women, the importance of this cannot be underestimated.

For many years, the medical establishment didn’t believe women could even experience heart disease, because cases and symptoms were never observed or recorded.   Even after this realization, research continued to be conducted only on male subjects and women's treatment was systemically delivered less aggressively than treatment for male patients.  Unsurprisingly, women showed a much higher incidence of mortality from heart disease.  It is only within the last 10 years that the scientific community finally acknowledged and began steps to remedy the gender bias in heart disease research and treatment.

Yet, women still have a higher mortality rate from heart disease due to the lingering effects of this gender bias.  While enormous steps have been taken to close the disparity, our culture still assumes a male patient and perspective on this issue.  We need to escape this mindset if we are going to fix this problem.  It's common sense: we must research and acknowledge the unique needs, lifestyles, and biochemistry of women if we are to provide the best life outcomes for women.  

An important first step is simply to spread awareness.  I was not aware of the ways that heart attack symptoms present differently in women, and I'm sure that I am not alone.  This needs to be common knowledge, so please spread this information to the women (and men) in your life!  Let's start talking.