Massive imbalance in heart attack treatment and care, survey finds

Australian women who suffer a heart attack are less likely than men to receive lifesaving treatment, be given heart health advice or be referred to cardiac rehabilitation.

A Heart Foundation survey of 400 heart attack survivors found women were “less likely than men to receive advice on how to control or reduce their risk factors for heart disease (76 per cent versus 85 per cent) or be referred to and attend cardiac rehabilitation after leaving hospital (39 per cent versus 51 per cent)”.

“At every step of the patient journey from prevention, to diagnosis, treatment and ongoing care, women often fare far worse than men,” said Julie Anne Mitchell, Heart Foundation director of health strategy.

“Women are less likely to have heart health checks, are slower to respond to the warning signs of a heart attack and even when they present to hospital, they are less likely to receive the same lifesaving treatments as men.

“For example, women are significantly less likely than men to have procedures to restore blood flow to the heart, less likely to have heart X-rays known as angiograms and less likely to have bypass surgery.”

Doctors often misdiagnose women having a heart attack, attributing symptoms to anxiety and indigestion. Making it more difficult is the fact that women are far less likely to exhibit chest pain symptoms commonly associated with men’s heart attacks.

“Chest pain is a common warning sign, but women are more likely to experience heart attack warning signs such as nausea, fatigue, shortness of breath, cold sweats, pain or discomfort in the jaw, hands, arms or back. These are symptoms that can be mistaken for conditions such as the flu, overexertion or just feeling run down rather than a life-threatening heart attack.

“The fact is that heart disease is not just a male problem. Twenty women die of heart disease each day.”

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In the US, research has found women are “more prone to heart disease and heart conditions after emotional stress, compared to men”.

This has become highly relevant given the “staggering” rise in mental health disorders after the onset of the COVID pandemic.

“Negative thoughts and mental health disorders including depression, anxiety and chronic stress, have been shown to directly activate the part of the nervous system that triggers the ‘fight or flight’ response,” goodmorningamerica.com reports.

“Doctors say this response is not without consequences as it can lead to high blood pressure, elevated heart rates and insulin resistance, further increasing a person’s risk for heart disease and diabetes.”

The American Heart Association released a statement highlighting the links between heart health, mental health and overall wellbeing.

“When someone is under chronic stress and has negative attributes, this can lead to an inflammatory cascade that can impair the ability of the heart and arteries to function properly, ultimately leading to a heart attack or stroke,” said study lead Dr Erin Michos, director of women’s cardiovascular health at Johns Hopkins University Hospital.

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A study recently published in the Journal of the American College of Cardiology concluded female heart disease patients fare better with female physicians.

Women make up over 50 per cent of internal medicine residents in the US but only 12.6 per cent of cardiologists are female. Women are also under-represented in clinical trials and medical education.

Study authors recommended an increase in gender diversity in the physician workforce; an improvement in gender and sex-specific medical training; and increased research on the role of gender in patient-physician relationships.

Another US study found increasing death rates from heart disease in women under 65.

“Women frequently put others’ health and needs before their own, often caring for children and parents and working full-time,” said Dr Michos.

“But if they have a fatal heart attack, they won’t be there for loved ones. Women must prioritise their own health, especially since heart disease is largely preventable.”

Heart disease is the main cause of death worldwide.

If you fear you’re having a heart attack call 000. Find out your risk of heart attack or stroke by using the Heart Age Calculator. For heart health information and support, call the Heart Foundation Helpline on 13 11 12 or visit www.heartfoundation.org.au

Do you know the signs of a heart attack? Do you know what to do if you have symptoms of a heart attack?

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Written by Will Brodie



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