Download this presentation: Women and Heart Disease 22611
The second floor conference room was filled to capacity for my talk this Tuesday. Most of those present were women. They listened very attentively for the entire 45 minute presentation, and there was a lot of head-nodding in affirmation and generally positive signals of an engaged audience. Then they stayed for 45 minutes to ask questions, The questions showed that they had “gotten it.” They were there for an hour and a half.
I made it clear that extensive research had been done to better define the needs of women at high risk for heart disease but that it had definitely not been translated. Not only that but this research had been actively undermined by the interventional cardiology community and conveniently ignored by hospital systems.
The audience contained three glaring examples of how women get the wrong message about their heart disease – often a dead wrong message.
The first was a diabetic woman in her late 60’s who has known moderate-to-severe branch vessel disease on cardiac catheterization, and who was just admitted to the hospital with chest pain. She had a negative stress test and was told that “the pain is not your heart”.
The second was a prediabetic younger woman, Judy Brooks, in her early 50s, who stood up after the meeting and told her story. Judy has had repeated atypical pains relieved by nitro-glycerin. She was recently very angry after she was treated almost rudely by an ER doctor who blew off her pain entirely. After a normal catheterization, she was told in no uncertain terms that her pain was “not her heart.” She has a calcium score in the 90th percentile.
The third was the daughter of our practice’s founder, a 42 year old woman who had severe pain and was told by three different doctors that it was not her heart. Thank goodness, when she called her father, he told her this was a real problem and she definitely needed help. She has had a heart attack and 4 stents.
It was very moving for me to hear these women describe the disconnect between what we do and what we know, and the personal implications for them.
Hospitals, interventional cardiologists, and insurance companies are not going to fix this. Their actions speak for themselves. Primary care can fix it and everyone wins. Are we ever going to do this?
Bill Bestermann MD is an internist turned vascularist. He practices at the Holston Medical Group in Kingsport, TN.