Studies show that women with heart disease are more likely than men to be misdiagnosed, and if they do have surgery, the results will be worse. Why is this bias happening, and how can it be fixed?
As a result, women continue to have a disproportionately high rate of undiagnosed or delayed heart disease. Women who present to hospitals with heart attack symptoms are consistently and tragically let down by the medical establishment. It has been a hard road for me as a professor of cardiac science with 40 years of expertise to get to the root of the issue, which is a mix of professional, systemic, and technical prejudices. Individual patients’ experiences are difficult to analyse and interpret, but we can now see the cumulative effects on a far larger scale.
Misdiagnosis of a heart attack is more common in women, increasing the risk of death by up to 50%. Initial misdiagnosis increases mortality risk by 70%. Similar to previous research, recent studies have indicated that female patients fare worse than male patients after undergoing heart surgery, specifically valve replacements and peripheral revascularization. Women are less likely to receive a correct diagnosis, the best surgical treatment, and the optimal set of medicines before being discharged from the hospital. Although none of this can be justified, is it at least comprehensible?
Seeing a woman having a heart attack is “unexpected,” it is said because women are less likely to get heart disease than males. Women may indeed be more likely to ignore the warning signs of a heart attack because they don’t think they’ll experience one. Yet the explanations I frequently hear from doctors leave me dubious. Although younger women may experience a lower incidence of heart disease, this condition is by no means uncommon. There are around 30,000 female heart attack hospital admissions in the UK annually.
Three to five young women can be seen by a doctor for every 10 young men diagnosed with heart disease, and the ratio improves with age. It’s not like a general practitioner will see more than a couple of instances of meningitis in their entire career, for example. About 21% of women die from heart disease throughout their lifetime, which is not too far from the 24% proportion for males. Seeing a female patient in casualty who is suffering from heart disease is not an unusual occurrence for doctors.
275 million women were diagnosed with cardiovascular disease (CVD) in 2019. Acknowledging sex and gender-specific risk factors is the key to understanding #CVD in women and reducing the 🌍 burden.
The second common justification is that women’s symptoms are inexplicable. However, the truth is that there is a lot of crossover between the sexes in terms of the symptoms people feel. Common symptoms include nausea, sweating, and dizziness, as well as the typical feeling of crushing chest pain, which can spread to the arms and jaw. This discomfort is the most prevalent symptom in both sexes, albeit it occurs more frequently in the back of women than males. Again, many people who visit the emergency room report feeling exhausted or short of breath, but women have a higher chance of presenting with these symptoms than males do. There is no reason to be uninformed about the wide variety of symptoms associated with heart attacks in women, given the large majority of patients who will be female.
Once a heart attack has been suspected, the patient’s care must adhere to strict norms and standards. If a doctor suspects a woman has heart disease, she should treat her with the utmost care. This, however, is not the case. Rather than using the current arsenal of treatments, clinicians are less likely to follow the standards when treating women. Despite being the most effective treatment available, women are less likely to undergo catheter-based angioplasty to unblock blocked blood arteries.
Nearly twice as many men as women survive hospitalisation, according to a study of more than 100,000 patients, and males receive 20% more of these reperfusion therapies than women do. Women are less likely to receive immediate care, even when they do. Each additional five minutes it takes to get to the catheter laboratory where reperfusion therapy can be administered raises the patient’s chance of death by 5%. The study also indicated that the greater mortality rate was due in part to the fact that women were transferred to the catheter laboratory far more slowly than men.
However, the study’s most shocking statistic was that this only happened if the doctor was male. Why should this be?