Even though coronary heart disease is the leading cause of death among women in the United States, the medical profession has been slow to address the issue as one important to both genders. For years, the focus has been on the well-known dangers the disease poses to men. A new study indicates that part of the problem is that symptoms of coronary heart disease differ in men and women -- a difference that can lead to misdiagnosis or the failure to diagnose the disease in women.
A recent study published in the Archive of Internal Medicine shows that women are significantly less likely to experience chest pains than men. When they do experience pain and go to a doctor, the results of an angiogram (a look at the coronary arteries) can show no evidence of heart disease. What researchers have found is that in many of these women, the pain was an indication of a disease in its infancy rather than in an advanced, more noticeable and measureable state.
The study authors recommend that women who experience chest pain undergo further testing for coronary artery disease. In the past, these women were deemed low risk and were often sent home without treatment. Now researchers say the patients should undergo assessment for endothelial dysfunction (a test of the arteries and lining of the heart). Even if those tests come back negative, doctors are encouraged to aggressively work to modify patient risk factors for heart disease, including smoking, obesity and high cholesterol.
Health care providers are missing opportunities to address the risks of coronary heart disease in women, researchers say. According to nationwide data, in routine heath care visits, women are less likely than men to receive counseling regarding nutrition, physical activity and weight reduction. It has also been shown that most women with confirmed coronary heart disease are not treated with lipid-lowering medications for high cholesterol.
The failure to diagnose coronary artery disease can have a devastating effect on female patients, who lose a valuable chance to receive treatment before a heart attack or stroke occurs. Women must be more proactive with their physicians by insisting that they receive the necessary tests to determine if they have heart disease, particularly, where there is a positive family history of heart disease.