Why Women's Heart Disease is Misdiagnosed

There's a reason that women are often misdiagnosed after a heart attack. In women, heart disease is more likely to occur in the small blood vessels, not major arteries as is generally the case for men.

Women's hearts are less likely to lose their ability to pump blood after a heart attack. Female heart patients also are not as likely to present with obstructive coronary disease. Instead oxygen deprivation, which creates damage to the heart, tends to happen when small blood vessels become dysfunctional.

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Dr. C. Noel Bairey Merz, director of the Women’s Heart Center at Cedars-Sinai Heart Institute, said that is the reason that women are often misdiagnosed and suffer adverse events.

She said that doctors have been looking for male pattern heart disease, when they should be looking for female patterns instead. Dr. Bairey Merz also urged additional research to develop appropriate treatments and to reduce the risk in women.

Men and women are affected by heart disease within different ways. While about 25 percent of men will die within one year of a heart attack, 38 percent of women die within the year after a heart attack. Women also are twice as likely as men to have a second heart attack within six years of the first one, and females are twice as likely to die after bypass surgery.

However, women are more likely to maintain their heart's ability to contract and pump blood from chambers into the arteries. The positive news, Dr. Bairey Merz, said, is that it is possible to objectively measure small blood vessels through reactivity testing, angiograms, and other physiologic means.

Dr. Bairey Merz recently presented the review study at the Physiology of Cardiovascular Disease: Gender Disparities conference at the University of Mississippi.