Women Heart Patients Face Obstacles to Diagnosis, Recovery

More than one-half of women with heart disease are dissatisfied with their health care and face significant obstacles to their recovery, according to the first-ever national survey of women heart patients. The results of the survey are published in the January/February edition of Women's Health Issues.

Of those who were dissatisfied with some aspect of their health care, 58 percent pointed directly to physician attitudes and communication styles as the culprits. Specifically, they cited physician insensitivity, rudeness, abruptness and ignorance about heart disease in women.

"This survey is a wake-up call for health-care professionals who need to understand how much their attitudes and communication styles influence their female patients' willingness to ask questions, participate in medical decisions, and adhere to recommended treatment and lifestyle modification," says Sharonne Hayes, M.D., Director of Mayo Clinic Women's Heart Clinic and co-author of the article. "It also underscores the need to recognize and treat the anxiety and depression that so often accompany heart disease in women."

Over one-half (57 percent) of the women said they had suffered a mental illness as a result of their heart disease, ranging from anxiety (17 percent) to clinical depression (38 percent), or both (21 percent). Many felt socially isolated or without social support systems and that "no one understood what [they] were experiencing." In addition, 27 percent said relationships with their families had deteriorated following their cardiac diagnosis, often because they could not adequately perform their responsibilities at home.

Most women also said they had difficulty making necessary lifestyle changes due to inadequate information and social supports, or lack of insurance coverage for nutrition counseling and weight-management services.

The survey involved telephone interviews with 204 women heart patients and was funded by WomenHeart: The National Coalition for Women with Heart Disease (www.womenheart.org), the nation's only patient-advocacy organization founded by and for women with heart disease.

While most surveyed women who had coronary artery disease experienced typical cardiac symptoms such as chest pain and arm pain or pressure, or shortness of breath, an almost equal proportion reported symptoms less commonly associated with a cardiac diagnosis, including dizziness, nausea, fatigue or back pain. They emphasized the need for early detection and accurate diagnosis of heart disease in women.

"Some cardiac diagnostic tests are affected by women's breast tissue and the rise and fall of menstrual hormones," says Dr. Hayes. "That's why tests other than standard electrocardiograms may be necessary, such as exercise or pharmacologic stress tests, nuclear scans or echocardiograms."

"These are very disturbing results," says Nancy Loving, WomenHeart's executive director and herself a heart attack survivor. "Only 35 percent of the women patients initially recognized their symptoms as heart-related and 45 percent felt their heart disease "came out of the blue.' Women need to realize heart disease is their number one killer and seek out health-care professionals who are well-versed in women's cardiac risks and symptoms, as well as which diagnostic tests and treatments work best in women."

WomenHeart provides copies of its free brochure, How Do I Know I Have Heart Disease? A Woman's Guide to Diagnosis and Testing, to women sending an e-mail request to [email protected] or writing to WomenHeart at: 818 18th Street, NW, Suite 730, Washington, DC 20006.