Gene Pitney was sadly misinformed when he sang, “Only love
can break a heart; only love can mend it again”. Each year,
nearly 500,000 women die of cardiovascular disease. Heart attacks
kill six times as many women as breast cancer annually. Women are
almost twice as likely as men to die after bypass surgery. Although
more women than men die of heart disease each year, women receive
only 33% of angioplasties and bypass surgeries, 28% of implantable
defibrillators and 36% of open-heart surgeries. Women are less likely
than men to receive beta-blockers, ACE inhibitors or even aspirin
after a heart attack.
In addition to the disturbing medical statistics, the first national
survey of women heart patients found more than half were dissatisfied
with their health care, particularly physician communication styles.
Many women lacked adequate information about heart disease. Most women
reported difficulty making necessary lifestyle changes due to inadequate
information and social support or lack of insurance coverage for nutrition
counseling and weight management services. WomenHeart, the National
Coalition for Women with Heart Disease, funded the survey. WomenHeart
is a non-profit organization founded by and for women with heart disease
that provides support, education and advocacy services. The survey
results have been published in the January/February edition of Women’s
Health Issues.
Over half (57%) of the women surveyed said they had suffered a mental
illness as a result of their heart disease, with 38% reporting clinical
depression, 17% reporting anxiety and 21% reporting both. Many women
described feeling socially isolated or without social support systems
and that no one understood what they were experiencing. 27% said their
family relationships deteriorated following their cardiac diagnosis
because they could not adequately perform their responsibilities at
home.
Only 35% of the women patients initially recognized their symptoms
as heart related and 45% felt their heart disease “came out
of the blue”.
Of women who were dissatisfied with their health care, 58% noted
physician attitudes and communication styles. Physician insensitivity,
rudeness, abruptness and ignorance about heart disease in women were
their chief complaints.
Cardiologist Dr. Sharon Hayes, director of Mayo Clinic Women’s
Heart Clinic, co-authored the article. She says “This survey
is a wake up call for healthcare professionals who need to understand
how much their attitudes and communication styles influence female
patients willingness to ask questions, participate in medical decisions
and adhere to recommended treatment and lifestyle modification. It
also underscores the need to recognize and treat the anxiety and depression
that so often accompany heart disease in women.”
While many women had experienced typical cardiac symptoms like chest
pain, arm pain or pressure, or shortness of breath, an almost equal
proportion reported less publicized symptoms like dizziness, nausea,
fatigue or back pain. When asked what advice they would give other
women, survey respondents most frequently said “Educate yourself
and ask questions” and “Listen to your body and don’t
ignore your symptoms.” The women also urged women to “Find
doctors who are attentive, understanding and knowledgeable about heart
disease in women – and follow their advice.”
Dr. Hayes says, “Some cardiac diagnostic tests are affected
by women’s breast tissue and the rise and fall of menstrual
hormones. Tests other than standard ECG may be necessary, like stress
tests, nuclear scans or echocardiograms.”
The information collected by WomenHeart indicates that the eight
million American women living with heart disease are not receiving
the information, support and diagnostic procedures they need to fight
women’s leading cause of death.
The way to a woman’s heart was traditionally paved with compliments,
chocolate and flowers. The new path needs to include early detection,
accurate diagnosis and proper treatment of heart disease. Until health
care providers establish protocols and practices that reflect specific
female needs and responses, women must remember that love isn’t
all that can cause a broken heart. PL
For the free brochure How Do I Know I Have Heart Disease? A Woman’s
Guide to Diagnosis and Testing, email a request to diagnosis@womenheart.org
or write to WomenHeart, 818 18th Street, NW, Suite 730, Washington
DC, 20006. For more information, visit www.womenheart.org.
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