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Women's Hearts Endangered: Guidelines Ignored

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There's bad news for women and their loved ones. If you're a woman having the most serious type of heart attack and you get to the hospital, you're less likely than a man to receive proper treatment and less likely to survive.

The American Heart Association has established guidelines for hospitals to follow which include specific protocols for optimal diagnosis and treatment to save the lives of patients that are having heart attacks.

A recent study published in Circulation: Journal of the American Heart Association reviewed the data of 420 hospitals that enrolled in the guidelines program. Dr. Hani Jneid, assistant professor of cardiovascular medicine at Baylor College of Medicine and lead author of the study, showed that hospitals don't seem to be following these guidelines closely enough, especially with their female patients. The researchers looked at gender differences of care practices and in-hospital deaths of 78,254 patients from 2001 to 2006. In sum, the study showed that if you're a woman having the most serious type of heart attack (a ST-wave elevation myocardial infarction), you're less likely to receive treatments to restore blood flow, like clot busting drugs, angioplasty and stenting, or life saving drugs, such as aspirin or beta blockers.

It's appalling that with the American Heart Association guidelines in place, hospitals are not using enough evidence-based treatments to save women's lives. In some cases, it may be as simple as giving a woman an aspirin.

A problem that potentially worsens the outcomes for women is when they fail to recognize possible heart attack symptoms and they delay getting to the hospital. Over half of the women stricken by heart attacks have more diverse symptoms than men do. But a large percentage of women and health care professionals don't know this fact. It's no wonder that one-third of the women who die of heart attacks have few or no reported symptoms.

A large percentage of women and health care providers still don't know that heart disease is the No. 1 killer of women, just as it is for men. And most women still don't think it can happen to them. Many still think of heart disease as a "man's disease." But the fact is that since the early 1980s more women than men have died of heart disease in this country.

Health care providers need to put heart disease closer to the top of their differential diagnosis list when it comes to women, not at the bottom. The lack of awareness and education of both women and their health care providers must improve to effect change and to save lives.

Here are some heart attack warning signs that women should know, taken from the Web site of American Heart Association and WomenHeart, The National Coalition for Women with Heart Disease:
-- Discomfort, fullness, tightness, squeezing or pressure in the center of the chest that stays for more than a few minutes or comes and goes.
-- Pressure or pain that spreads to the upper back, shoulders, neck, jaws, arms or stomach.
-- Dizziness or nausea.
-- Clammy sweats, heart flutters or paleness.
-- Unexplained feelings of anxiety, fatigue or weakness -- especially with exertion.
-- Shortness of breath and difficulty breathing.
What should you do if you are having several of these heart attack warning signs?
-- Call 911 for an ambulance. Do not drive yourself. Do not delay. (Time is heart muscle!) At the hospital, tell staff that you are having heart attack symptoms.
-- Chew and swallow with water one regular full-strength (non-coated) aspirin as soon as possible to prevent blood clotting.
-- Insist that the hospital staff takes your complaints seriously, does not make you wait and gives you a thorough cardiac evaluation including an electrocardiogram (EKG). An echocardiogram and a blood test to check your cardiac enzymes may also be performed.

For more information about WomenHeart, visit www.womenheart.org or for the American Heart Association, visit www.americanheart.org.

Another way you can help:
Attend the Cardiovascular Research Foundation's "The Art of Living Well: A Woman's Guide to Preventing Heart Disease" event on Thursday, February 11, 2009 at 11:30 am at Tavern on the Green in NYC. Speakers will be Kathy Kastan, LCSW/MAEd, Mehmet Oz, MD, Jean Chatzky and Gail Blanke. Funds raised will be used to fund gender specific fellowships and research. Please contact the CRF for reservations or information at (212)851-9187 or email idamhuis@crf.org.

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