Equal-Opportunity Disease Doesn’t Always Receive Equal Treatment
Nearly twice as many women die of coronary heart disease as from all forms of cancer combined. Women develop heart disease later in life than men (usually after menopause), but they die in equal numbers. Despite similar risk, men and women aren’t always treated equally for heart disease.
“Women’s symptoms often differ from men’s and are not as easily diagnosed by standard tests,” says L. W., M.D. “For example, in men, chest pain is the most common warning sign of a heart attack; in women, however, warning signs may appear less severe and therefore, could get overlooked.”
Chest pain in women correlates poorly with disease that can be seen on angiography (a test that shows any narrowing of the arteries). This makes it harder for cardiologists to classify and treat women with chest pain, and to predict the likelihood of a heart attack. Likewise, ECG treadmill testing is also less accurate in women than in men. Women are also significantly more likely than men to experience certain symptoms as warning signs: upper abdominal pain, shortness of breath, nausea and fatigue.
As a consequence of having atypical symptoms and less accurate diagnosis of their condition, women are sometimes under-treated for heart disease, numerous studies have found. Women are less likely to receive interventions such as balloon angioplasty, bypass surgery, and clot-busting drugs. According to the American Heart Association, women also tend to be less aggressively treated with proper medications following heart attacks and to be less involved in cardiac rehabilitation programs.
These gender differences in treatment, and the fact that women are often sicker and older when they seek medical care, are thought to partly explain why women are as much as two times more likely to die after a heart attack. Yet women respond to virtually all treatments and preventive measures equally to men, and should have an equal chance at a healthy life if their heart disease is successfully treated.
The scenario is looking brighter. New, more sensitive diagnostic tests and a heightened awareness among the medical profession are making treatment for heart disease more equitable between men and women.
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