Mary hurriedly sat down on her couch in her living room. The symptoms were starting again. Mary has had these symptoms on and off for over 4 years. She was constantly in and out of the emergency room. In fact, the emergency room staff knew her by name. The providers had diagnosed her with anxiety. She was already 50 years of age, and the providers knew that she was menopausal.
The symptoms that Mary experienced was acid reflux symptoms, right upper quadrant pain, and nausea. Even though the doctors had diagnosed Mary with anxiety, Mary knew her body and she knew something was wrong. The only anxiety Mary had was when she would go to the emergency department and the doctors would dismiss her symptoms as anxiety.
Since Mary was a nurse, she knew these symptoms were abnormal, but she could not figure out what was causing them. She decided to go to another emergency department at a teaching hospital.
Mary checked into the new hospital and the doctor evaluated her and came back with a diagnosis of GERD and anxiety. The doctor went to prepare the discharge instructions, and then the nurse came back with a GI cocktail. Mary proceeds to tell the nurse about her ongoing symptoms.
The nurse started to think about Mary and her symptoms. The nurse knew that women presented much differently than men for heart disease. The nurse also recognized that Mary had symptoms of heart disease. The nurse went back to the doctor and asked him to do a cardiac workup. The doctor agreed and cancel the discharge and to do a chest x-ray, a troponin level, and an EKG.
The nurse did an EKG and recognized it was abnormal because it showed the patient had a prolonged QT interval. At that time, the nurse did a troponin check and the troponin was elevated. The x-ray showed cardiomegaly. The provider then recognized that this patient could have a cardiac event going on.
The emergency doctor called for a consult with a cardiologist, and the patient was admitted. A cardiac cath showed three-vessel disease and the patient had to have an emergency bypass.
Women, Heart Disease, and Statistics
There are a plethora of women who go through what Mary went through. Often times, women present to the emergency department with these symptoms, and they are told it is just anxiety.
Heart disease is now the leading cause of death for women in America. According to the Centers for Disease Control, approximately 25% of women in America die from heart disease. Heart disease has traditionally been thought of as a man’s disease.
However, statistics show that the same number of women as men die of heart disease. Perhaps this fallacy came from research decades earlier that stated women were protected by estrogen. Therefore, providers had the false assurance that “younger” women were not susceptible to heart disease. More recent research has shown this not to be true.
Heart Disease is even more harmful to African- American women. Approximately 8% of African-American women have coronary artery disease. Thirty-three percent of women who die suddenly of heart disease have no symptoms.
Even armed with these statistics, women are still not diagnosed as readily as men are with heart disease. A study was performed by the Canadian Medical Association that revealed that women are dying at a faster rate than men of heart disease. Also, hospitalization rates have increased for women and declined for men.
Signs and Symptoms of Heart Disease in Women
Women have different symptoms than men for heart disease. This is one of the reasons that women are not “easily diagnosed”. Health providers are using the standards identified for men.
The symptoms for women are:
Nausea and vomiting
Stomach pain or acid reflux (GERD) symptoms
Right upper quadrant pain
Upper back and mid back pain
When women do have chest pain, the chest pain is described as a burning sensation. Often time, there are no symptoms until a woman has a heart attack or stroke. Also, there are such vague symptoms, the diagnosis could be a host of many other disorders.
Awareness of Heart Disease and Women
The American Heart Association created the Go Red For Women Campaign to create awareness of women’s heart disease. This campaign empowers women everywhere to take charge of their heart health. These measures include:
Monitoring your blood pressure
Maintaining a normal weight
Exercising at least 3 times a week
Monitor your cholesterol
Monitoring your blood pressure
Get your annual physical exams
Emergency doctors are usually the first doctors that women with heart disease come in contact with. These providers should be armed with the latest research about women and heart disease.
According to the American Heart Association, 80% of cardiovascular events that women have can pre prevented with the proper lifestyle and adequate treatment.
Most women have families, and they tend to put others needs in front of theirs. As women, we need to better take care of ourselves, and make the commitment to better health.
Have you had any experiences where women were wrongly diagnosed? Have you been wrongly diagnosed? To join the discussion, leave your comments below.
Daugherty SL, Masoudi FA, Ellis JL, Ho PM, Schmittdiel JA, Tavel HM, et al. Age-dependent gender differences in hypertension management. Journal of hypertension. 2011;29:1005–1011
www.goredforwomen.org. (2019). Go Red For Women®. [online] Available at: https://www.goredforwomen.org/ [Accessed 2 Feb. 2019].