Heart disease symptoms in women more likely to be misdiagnosed

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Research by the American Heart Association reveals differences in the heart attack symptoms for women are at the center of higher rates of misdiagnosis, dismissal or delays in diagnosis for women.

“There really is no excuse in health care for knowing, as we have for the past 20 years, that women are under diagnosed in heart disease and it continues,” said Dr. Robert Lancey of Bon Secours Health Systems. “There’s no excuse for that.”

Dr. Lancey and Monica Reed of Bon Secours are working to educate women and doctors to take action and take a closer look when women show up for help.

“When they arrive in the emergency department, sometimes those atypical symptoms are discounted by the staff,” Reed said.

While many men experience the "elephant on the chest" feeling, women can show heart disease symptoms differently. They may have jaw pain, neck or back pain, nausea, vomiting or shortness of breath. Studies show that not only do women wait longer than men to seek help, they are more likely to be dismissed, misdiagnosed or experience delays in diagnosis when they seek medical attention.

“They are much less likely to be referred for more advanced diagnostic testing,” Dr. Lacey said.

study in the Circulation Journal of the American Heart Association showed that in some cases, the initial evaluation for heart conditions, like an EKG, came back fine only for doctors to find something days later after several visits.

“A lot of times if they`re doing a cardiac workup in the [emergency department], that`s part of that comprehensive workup,” said Reed. “If all of that comes back normal, they are going to discharged you from the E.D. as a low risk patient.”

However, Dr. Lancey added “The EKG will often be normal when they may have significant heart disease.”

Doctors said part of the solution to the disturbing trend is for women to know their risk factors: obesity, family history, smoking, high blood pressure, diabetes and high cholesterol. They also stress the importance of knowing those sometimes subtle signs and symptoms special to women.

Kathryn Moore of Hampton had severe jaw pain that sent her to the hospital. The emergency department doctor knew to test for signs of a heart attack, and checked her troponin hormone levels which can show if someone is having a heart attack if other tests come back normal.

“My cardiologist told me that if I hadn`t, I would have been dead within a week. Moore said.

Dr. Lancey said do not take no for answer if you feel your concerns are not being heard at the hospital.

“Don`t give up and just say, ‘Look I`m really concerned’,” Dr. Lancey advised.

“They have that feeling of impending doom, don`t discount that feeling,” said Reed. “People get that for a reason. If you know something is wrong, continue to advocate until somebody hears you.”

The AHA urges women to ask their doctor to screen for heart disease during their regular visits. Heart scans are now being reimbursed by Medicare.

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