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Why Women's Heart Disease Is So Frequently Ignored or Neglected

According to recent research, women may not be aware that their symptoms are indicative of heart problems, and doctors may not be recognising them either.

Nearly 700,000 people die from heart disease each year in America, making it the number one killer of both men and women. But research has long indicated that women are more prone than males to ignore the signals of a heart attack, sometimes delaying for hours or even days before dialling 911 or visiting a hospital.

Now, scientists are attempting to determine why. Despite having more subtle heart attack symptoms than males, women frequently put off seeking treatment. Even when they do go to the hospital, medical staff were more likely to minimise or put off treating their symptoms. The underdiagnosis and undertreatment of heart disease in women, according to health officials, contributes to poorer results for women and higher rates of death from the condition.

According to the majority of studies, women postpone seeking medical attention frequently and are misdiagnosed in part because of the symptoms they experience. Although both sexes experience chest pain or discomfort as the first indicator of a heart attack, women are much less likely than males to experience any chest pain at all. Instead, they frequently experience symptoms including shortness of breath, cold sweats, malaise, weariness, and jaw and back pain, which can be more difficult to link to heart problems. According to a study by the American Heart Association, women who do not experience chest pain are more likely to die from heart attacks, in part because it takes longer for patients and medical professionals to diagnose the condition.

However, women still have a tougher time getting treated than men do when they think they are having a heart attack. According to studies, they are more likely to hear that their symptoms are unrelated to their cardiovascular system. Doctors frequently tell women that their problems are all in their heads. According to one study, women who reported symptoms of cardiac disease, such as chest pain, were twice as likely to be given a mental illness diagnosis than men who reported the same symptoms.

Wait times are longer and diagnoses take longer for women.

In a study this month in the Journal of the American Heart Association, researchers examined information on millions of visits to emergency rooms prior to the pandemic and discovered that women, and particularly women of colour, had to wait an average of 11 minutes longer than men with similar symptoms before seeing a doctor or nurse. Women were less likely to be admitted to the hospital, to get thorough examinations, and to have tests like an electrocardiogram, or EKG, which can identify cardiac issues, done to them.

A patient who visited numerous doctors complaining of jaw pain was eventually referred to a dentist, who pulled two molars, When the woman's jaw pain persisted, she went to see Dr. Lansky, who found that the issue was heart-related. The director of the Yale Cardiovascular Research Center, Dr. Lansky, stated that the patient ultimately underwent bypass surgery since the jaw pain was caused by heart disease.

Through a number of public service efforts over the years, health officials have attempted to reduce the gender gap in cardiovascular care. In addition to the Women's Heart Alliance, which began running advertisements on Facebook, Instagram, and thousands of radio and television stations last year, the federal government, the American Heart Association, and other organisations have launched campaigns to raise awareness of heart disease and its symptoms among women. The group's advertisements, which use Lady Gaga's song, exhort women to "know the indications" of a heart attack, which they are advised can be as ambiguous as perspiration, dizziness, or extreme exhaustion.

A study on the reasons why women put off getting help for heart problems was released in January by a team of academics. They discovered that one of the main factors was the absence of chest pain or discomfort. The study examined 218 men and women who received heart attack treatment at four different hospitals in New York prior to the pandemic. It was published in the journal Therapeutics and Clinical Risk Management.Compared to just 36% of the men, it was shown that 62% of women reported no chest pain or discomfort. Numerous women also complained of gastrointestinal issues like nausea and indigestion, as well as shortness of breath. One-fourth of the men additionally mentioned experiencing either breathing difficulties or stomach problems.

In the end, compared to 54 percent of males, 72 percent of women who had a heart attack waited more than 90 minutes to visit a hospital or dial 911. Compared to 36 percent of the men, slightly more than half of the women called a friend or family member before calling 911 or visiting a hospital.

In younger women, heart disease is on the rise.

According to Dr. Jacqueline Tamis-Holland, a cardiologist at Mount Sinai Morningside in New York and one of the study's authors, "There is a dearth of knowledge among both women and men that a heart attack does not have to generate chest pain or these spectacular movie-like symptoms."

Other factors, according to Dr. Tamis-Holland, contributed to the delays. One is that women do not think they are as prone to heart disease as men do. They are more inclined to write off their symptoms as stress or anxiety, according to prior studies. Additionally, they typically get cardiac disease later in life than do males. The average age of the men in Dr. Tamis-study Holland's was 61, whereas the average age of the women who experienced heart attacks was 69.

However, young women are still susceptible to heart disease. In fact, recent research has shown that women between the ages of 35 and 54 have an increased risk of having a heart attack and dying from the condition, in part due to an increase in cardiometabolic risk factors like high blood pressure and obesity.

Dr. Lansky of Yale-New Haven Hospital stated, "I think a lot of young ladies cannot believe they have heart disease since it's never been classified as a condition of young women." "Second, symptoms in younger women are even less common — there is less of the feeling of an elephant on the chest and more indigestion, shortness of breath, malaise, exhaustion, and nausea — things that are not very specific. They find it challenging to recognise it as a problem because of that.

More outreach and education, according to experts, are required to help both men and women identify the warning symptoms and risk factors for heart disease. But according to Dr. Lansky, she also wants to give them the tools they need to advocate for themselves. She advised people to not let medical professionals turn them away if they have concerns about their health until they have answers.

"You should spell it out," she advised if you're not feeling well and believe that a heart problem could be the cause. Nobody working in the emergency room will deny you access to something. However, sometimes they simply aren't considering it, so it's wise to highlight it.

When describing their symptoms, patients should be as specific as possible, according to Dr. Lansky, as this can help doctors make a more accurate diagnosis. In addition, she made the point that the Hollywood portrayals of people gripping their chests during a heart attack may be deceiving because, more often than not, people feel tightness or pressure in their chests due to heart disease rather than agony. In addition, they could experience unexpected exhaustion or shortness of breath after light exercise. "That should raise a red signal," she advised, if you used to run up and down the stairs without stopping.

Dr. Lansky recommended women to participate in cardiovascular medicine-related clinical trials. She emphasised that studies involving men account for a large portion of what is known about heart disease. Only 20 to 25 percent of participants in research trials looking at interventions for heart attacks are women, according to her. One explanation is that for many years, health officials excluded women out of concern that their pregnancy or hormonal changes would affect study outcomes.

Dr. Lansky stated that "many times, our suggestions are based on evidence that is derived from male patients." "It's difficult to incorporate more women in cardiovascular medicine. Despite all the challenges, it's crucial to promote participation in clinical investigations. That's a significant one if you want to do something for humanity.