But when women suspect they are having a heart attack, they still have a harder time getting treated than men do. Studies show they are more likely to be told that their symptoms are not cardiovascular related. Many women are told by doctors that their symptoms are all in their head. One study found that women complaining of symptoms consistent with heart disease – including chest pain – were twice as likely to be diagnosed with a mental illness compared to men who complained of identical symptoms.
WOMEN FACE LONGER WAITS AND SLOWER DIAGNOSIS
In a study published this month in the Journal of the American Heart Association, researchers analysed data on millions of emergency room visits before the pandemic and found that women – and especially women of color – who complained of chest pain had to wait an average of 11 minutes longer to see a doctor or nurse than men who complained of similar symptoms. Women were less likely to be admitted to the hospital, they received less thorough evaluations and they were less likely to be administered tests like an electrocardiogram, or EKG, which can detect cardiac problems.
Dr Alexandra Lansky, a cardiologist at Yale-New Haven Hospital, recalled one patient who had gone to multiple doctors complaining of jaw pain, only to be referred to a dentist, who extracted two molars. When the jaw pain didn’t go away, the woman went to see Dr Lansky, who discovered the problem was heart related. “She ended up having bypass surgery because the jaw pain was heart disease,” said Dr Lansky, who directs the Yale Cardiovascular Research Center.
Over the years, health authorities have tried to address the gender gap in cardiovascular care through a variety of public service campaigns. The federal government and the American Heart Association launched campaigns to increase awareness of heart disease and its symptoms among women, as did the Women’s Heart Alliance, which started placing ads last year on Facebook, Instagram, and thousands of radio and television stations. Set to music from Lady Gaga, the group’s ads urge women to “know the signs” of a heart attack, which it cautions can be as vague as sweating, dizziness or unusual fatigue.
In January, a group of scientists published a study that delved into the factors that drive women to delay seeking care for their cardiac troubles. They found that the absence of chest pain or discomfort was a major reason. The study, published in the journal Therapeutics and Clinical Risk Management, looked at 218 men and women who were treated for heart attacks at four different hospitals in New York before the pandemic. It found that 62 per cent of the women did not have any chest pain or discomfort, compared to just 36 per cent of the men. Many women reported shortness of breath as well as gastrointestinal symptoms like nausea and indigestion. About one-quarter of the men also reported having either shortness of breath or gastrointestinal distress.
Ultimately, 72 per cent of women who had a heart attack waited more than 90 minutes to go to a hospital or call 911, compared to 54 per cent of men. Slightly more than half of the women called a relative or a friend before dialing 911 or going to a hospital, compared to 36 per cent of the men.
HEART DISEASE IS RISING IN YOUNGER WOMEN
“There’s a lack of understanding in both women and men that a heart attack does not have to cause chest pain or these incredible movie-like symptoms,” said Dr Jacqueline Tamis-Holland, an author of the January study and a cardiologist at Mount Sinai Morningside in New York.
Dr. Tamis-Holland said there were other reasons for the delays. One is that women don’t consider themselves to be as vulnerable to heart disease as men. Previous studies have shown that they are more likely to dismiss their symptoms as stress or anxiety. They also tend to develop heart disease at later ages than men. In Dr Tamis-Holland’s study, the women who had heart attacks were, on average, 69 years old, while the average age of the men was 61.