Cardiology
Heart disease risk underestimated in women
Dr. Jonathan Byrne, UK Lead of the UK’s Valve for Life programme and a Consultant Cardiologist at King’s College Hospital, warns that heart disease is frequently underestimated and misdiagnosed in women. In this article, he highlights the key issues and the gender disparities in UK heart care services.
The UK health service will face substantial challenges in managing the increasing demand for treatment for heart conditions in the coming years. The projected rise is expected to be exacerbated by the ageing population, adding further strain to healthcare resources. Cardiac issues in women are a significant health concern. Heart failure is a leading cause of death for women; it is estimated that more than 300,000 women are admitted to hospitals in the UK annually due to heart attacks.1
Over 3.6
million women are affected by cardiac issues in the UK alone.1 Remarkably, the occurrence of heart attacks among women is still frequently characterised as ‘unexpected’ by healthcare professionals. It is often overshadowed by the misconception that heart disease is a ‘male’ problem. The risk of heart disease in women is frequently underestimated, stemming from the misunderstanding that females are inherently ‘protected’ against cardiovascular disease.1
Women are 50% more
likely to be misdiagnosed after a heart attack, and they often face delays in referral for diagnostic testing compared to men.2 The backlog for crucial heart care services continues to mount for both genders; it is estimated that over a quarter of a million people are waiting for tests and treatments in England alone.3
Alarmingly, the count of individuals
enduring waits exceeding a year for heart tests and treatment in England is much higher than pre-pandemic levels. Women with heart disease are more likely to be diagnosed late, leading to significant delays in receiving the correct treatment (possibly from the misconception among HCPs that heart problems are a ‘male’ issue). Women also face delays in receiving diagnostic investigations and treatment compared to men, a concerning trend that underscores gender disparities in healthcare, as they are often overlooked or misdiagnosed despite similar symptoms, leading to delays in crucial cardiac care. Factors such as
societal biases, atypical symptoms, and a lack of awareness among healthcare providers contribute to these delays.
Addressing gender disparities in cardiology If cardiology units are to readdress the disparities between male and female patients, then this begins with education and a prompt and accurate diagnosis when they first present to their GP or A&E department. Misdiagnosis can stem partly from the
prevailing perception that heart attacks primarily affect middle-aged men but are also due to subtle differences in symptoms and the reporting of symptoms by women. Cardiac problems can present with chest pain, which can mimic indigestion, shortness of breath, nausea, or extreme fatigue. It’s crucial for doctors to recognise these subtly different signs. Although the most common heart attack
symptom in women mirrors that of men – chest pain, pressure, or discomfort that persists – it
64
www.clinicalservicesjournal.com I November 2024
is more readily attributed to other causes, particularly in younger women, where a heart attack is often not considered as a differential diagnosis. Although much less common in women, the presence of typical symptoms should prompt rapid assessment and exclusion, with an ECG (electrical heart tracing) and blood tests to exclude heart muscle damage. This tendency to downplay symptoms or
attribute them to other causes can further contribute to the oversight of cardiac issues in women. Inadequate recognition and understanding of the presentation of heart disease in women, coupled with societal perceptions and stereotypes, can exacerbate the problem. These factors collectively hinder timely diagnosis and appropriate treatment, perpetuating the disparities in cardiac care experienced by women.
Oversight of heart valve issues There are also gender disparities in the diagnosis and treatment of valve disease. Aortic
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80
