Why do women’s hearts need attention?

..you might ask yourself.

Prof Burkhard Sievers from the German Society for Gender-Specific Medicine (Deutsche Gesellschaft für Geschlechtsspezifische Medizin e.V.) sums up the answer quite well:

‘Women are at a disadvantage in both the diagnosis and treatment of cardiovascular diseases due to the frequent occurrence of non-specific symptoms or incorrect or late categorisation of symptoms by doctors.’ [1]

In the report ‘Closing the Women’s Health Gap: A $1 Trillion Opportunity to Improve Lives and Economics´, the World Economic Forum reported that women are 7 times more likely than men to be misdiagnosed with heart disease or to be discharged during a heart attack. [2]
Although men suffer heart attacks more often, women are more likely to die from them. [2]
These are precisely the reasons why women’s hearts need to be more in the focus of medicine and why gender-specific differences in medical training need to be addressed in general.

General Facts about Cardiovascular Diseases [1]

• Cardiovascular diseases are the most common diseases and causes of death worldwide
• Every year, 18 million people worldwide die from cardiovascular diseases
• 340,000 people die from cardiovascular diseases in Germany every year
• 1.7 million people are hospitalised due to cardiovascular disease in Germany

How does the Symptomatology of ‘Cardiovascular Disease’ differ between Women and Men?

Men feel a feeling of pressure in the left chest that radiates into the left arm and the left jaw region when vessels are constricted or blocked. [1]

Similarly, a feeling of pressure in the left breast that radiates to the left arm and the left jaw region can also occur in women, but in 30 % to 40 % of cases this does not happen! Women often also experience non-specific complaints such as shortness of breath, poor performance, back pain, a feeling of pressure in the right half of the chest or in the upper abdomen or nausea. [1]

Risks for Women with a Cardiological Disease

The faster a heart attack is treated, the greater the chances of survival. However, women often suffer negative experiences in relation to the treatment of cardiovascular disease, which are as follows [1], [2], [3]:

• Women arrive at the emergency room on average one hour later
• Women have a 50% higher mortality rate in the year following a heart attack
• 37% more women than men do not receive a correct initial diagnosis after a heart attack
• Women are 12% less likely to be tested for risk factors than men

In addition, female heart patients are less likely to be prescribed secondary prevention to reduce further events when discharged from hospital. This and other risk factors contribute to the fact that women have twice the risk of dying from a serious heart attack. [2]

Even though heart attacks are more common in men, there are also cardiovascular diseases that occur much more frequently in women. These include heart attacks with non-obstructive coronary arteries, ‘broken heart syndrome’ (stress cardiomyopathy), coronary dissections or coronary spasms [1]. The diseases mentioned are not easy to recognise – especially if doctors are not trained in gender-specific differences [1]. This can result in a long patient journey until a diagnosis is made. If treatment is provided too late, this has a negative impact on the heart and patients lose valuable years of life [4]

How can Cardiovascular Disease Care for Women be improved?

Outcomes following an acute cardiac event could be improved through gender-specific protocols for guideline-compliant management. This needs to be applied at all levels of the entire treatment process – admission, diagnosis, treatment, discharge. [2]

‘It has been shown that a discharge checklist for guideline-compliant medical therapy can reduce mortality in patients with heart failure by 65% in both sexes.’

World Economic Forum

In healthcare, there is no one size fits all. Understanding the nuances of gender-specific medicine is critical to optimising patient care and improving health outcomes.

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Takeaway Points:

• Women are more likely to die from heart attacks despite their lower incidence compared to men.
• Women are at a disadvantage in the diagnosis and treatment of cardiovascular disease due to unspecific symptoms and late classification of symptoms.
• Symptoms of cardiovascular disease can be less specific in women.
• Women have a higher risk of misdiagnosis and dismissal during a heart attack compared to men.
• Women have poorer chances of survival after a heart attack due to delays in treatment.
• Women are less likely to receive appropriate initial diagnosis and secondary prevention.
• Gender-specific protocols and checklists can improve cardiovascular disease care.
• Understanding gender differences in medicine is crucial for optimising patient care.

For more Information

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