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Misdiagnosis, signs and symptoms of heart disease different in women

Second of a two-part series:
Many factors contribute to a higher rate of death from heart disease among women than men, primarily misdiagnosis by doctors, and women who are unaware of, confused by symptoms, and the risk factors that can accompany heart problems, according to Susan Laine of WomenHeart, the National Coalition for Women with Heart Disease.
“Women have a different experience than men when it comes to diagnosis and treatment of heart disease. For example, a strong predictor for coronary disease in women is having a low cholesterol level while in men the stronger predictor is high (bad) cholesterol,” said Tammy Roberts, nutrition and health education specialist with University of Missouri Extension. “Women are also less likely than men to survive heart surgery and women are less likely to receive aggressive treatment for heart disease.”
“Heart disease in women is routinely misdiagnosed by physicians,” said Laine. “Despite established hospital and physician guidelines for heart patients, more women are dying in the hospital after a heart attack because they do not receive the same care as men. Ninety percent of primary care doctors don’t know that heart disease kills more women than men.”
Early detection and management of key risk factors for heart disease can reduce a woman’s risk of developing heart disease by as much as 80 percent, said Laine. The problem is that too many women are unaware of their own risks for heart disease.
Women often ignore symptoms, thinking they are too young to experience a heart attack or that the symptoms should mimic those known to affect men.
Women should give close heed to “pain or pressure in the middle of the chest, shortness of breath, radiating pain to the shoulders, neck, back, arms or jaw, pounding heartbeats or feeling of extra heartbeats, upper abdominal pain, nausea, vomiting or extreme indigestion, unexplained sweating, dizziness with weakness, sudden extreme fatigue, or panic with the feeling of impending doom, said Roberts.
She also pointed out that about one-third of women having heart attacks experience no chest pain and more than two-thirds of women having heart attacks report flu-like symptoms for two to four weeks before developing a chest discomfort or severe shortness of breath.
The National Institutes of Health (NIH) indicates women’s symptoms “can be felt as long as a month before the actual cardiac event. In a study of 515 women, 95 percent said they knew something was different a month or more before experiencing a heart attack. The most common symptoms were fatigue (70.6 percent), sleep disturbance (47.8 percent) and shortness of breath (42.1 percent). Fewer than 30 percent reported experiencing chest pain or discomfort prior to their heart attack, and even though 43 percent reported having no chest pain during the attack, most doctors continue to consider chest pain the most important symptom in both men and women. Women in the study also reported experiencing indigestion and anxiety prior to having a heart attack. During the actual heart attack, the most common symptoms reported by women were shortness of breath and weakness.”
“Symptoms for heart attack can be different for women and men. That means it is important for women to know the symptoms that are more common for the ladies,” said Roberts. “It is also critically important for women to demand aggressive care when it comes to heart health.”
The HEART for Women Act was reintroduced to Congress on Feb. 12. If passed, it will fund programs to educate healthcare providers and women about the prevalence, warning signs and treatment of heart disease in women, authorize Medicare to conduct an awareness campaign for older women and require the Federal Food & Drug Administration (FDA) to report health data by gender, race and ethnicity in order to shed new light on physiological difference among specific populations.

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