If You're Going to Be Treated for a Heart Attack, Try Not to Be Female

The medical establishment doesn't have the best history of being proactive about keeping women healthy, but the problems usually when the disease affects a lady organ—breast cancer, cervical cancer, etc.—but now a major new study has found that women also get the short end of the stick when it comes to treating an organ that everybody has: the heart.

The study, which appears in the Journal of the American Medical Association, tracked more than 1.1 million patients from 1994 to 2006 and concluded that women who have heart attacks are less likely than men to get proper treatment, even when they have the same symptoms, and more likely to die in the hospital. While the results are quite literally heart-breaking, some cardiologists suspect that this study might actually underestimate the disparity because so many women who have heart attacks never even make it to the hospital for treatment. Ugh.

So what is causing this gender gap? Well, to begin with the study found that women are not as likely to get immediate treatment with things like clot-busting drugs and balloons that open arteries, which can stop a heart attack in progress. These delays contribute to the 15 percent of female heart attack victims that die in the hospital—whereas only 10 percent of men die.

Part of the reason for this delay is that women often do not present with classic heart attack symptoms like chest pains. Often women who don't have chest pain have other, more vague symptoms, like shortness of breath, nausea or vomiting, light-headedness, back or jaw pain, and crippling fatigue. Forty-two percent of women never had chest pains at all, but only 31 percent of men didn't. This can make all the difference, since the study found that patients without chest pain are almost twice as likely to die as those who have it.

Part of the problem with having less obvious heart attack symptoms is that it causes women to not take the symptoms they do experience seriously. So often women don't go to the hospital, when they might if they had chest pains. But even if we do make it to the hospital, our attitude toward our symptoms can influence how we're treated. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital and also an American Heart Association spokeswoman, explains:

We have a tendency to downplay what we're feeling. If you say to your doctors, "It's probably in my head," then the person who is listening starts dismissing it. If you think you're having a heart attack, say it. And if you're wrong, then you're wrong.

While doctors are obviously trained to look for symptoms other than chest pain, they do often fail to realize the seriousness of a heart attack patient's situation. Steinbaum says,

Women are coming in saying they're nauseous, they're fatigued, they're sweating, and doctors say, "You're fine." Doctors will say it's anxiety and it's all in your head.

As annoying and dismissive as this sounds—and is—there is also a legitimate reason for doctors to assume you're not having a heart attack. Study author John Canto says fewer than 20% of people who think they're having a heart attack are actually having one. And there are plenty of other ailments that can cause nausea and fatigue. But still, better for doctors to be overly cautious in a scenario like this.

Overall, the problem is one of education—women don't know the symptoms to look for and doctors don't recognize heart attacks from the symptoms a patient presents with. This means the opportunity for immediate treatment is lost, which results in worse outcomes. This study certainly should serve to wake doctors up and make them take treatment of women cardiac patients more seriously. And part of the responsibility lies with us too. Cardiologist Nieca Goldberg says,

When I ask my wife what is she most afraid of, she says breast cancer. And yet she is six times more likely to die of a heart attack. We have a desperate message to share about the risk of heart disease in women of all ages.

That means in addition doing the whole women's health/mammogram routine, we also need to be vigilant about our heart health—things like cholesterol, blood pressure, blood sugar all matter—and we need to seek treatment when any problems develop. Hopefully over time, this gender gap will close and maybe heart attacks won't happen to anyone anymore, but until then, if nothing else, this information should give you the push you need to be as aggressive as you need to be to get medical attention if you even so much as think you're having a heart attack.

Women less likely to get immediate heart attack treatment [USA Today]

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