Heart Disease Evades Detection In Many Women Despite Signs
Washington – Conventional tests won’t uncover heart disease in as many as three million U.S. women – because instead of the usual, bulky clogs in main arteries, these women have hear-to-spot buildups in smaller blood vessels, researchers said. These are the women who come to the doctor complaining of chest pain or shortness of breath but sometimes are sent away undiagnosed, not knowing they are at high risk for heart attacks in the next few years.
“The No. 1 message for women is, ‘Pay attention to your symptoms’,” said Dr. George Sopko, a heart specialist at the National Institute of Health, which sponsored the research. “If you don’t have visible blockages, that doesn’t mean you’re not at risk.”
Heart disease is the nation’s leading killer of both men and women. In fact, slightly more women than men die from cardiovascular diseases each year – more than 480,000 of them, according to the American Heart Association.
Scientists are struggling to understand gender disparities: Women are less likely to receive aggressive treatment for heart disease than men, are less likely to survive heart surgery and respond differently to different risk factors and therapies. They frequently have different heart-attack symptoms than men, such as fatigue instead of chest pain radiating down the arm.
Even the test considered best at diagnosing heart disease – angiography, which lets doctors watch as blood flows through key arteries – is less accurate for women than men.
Reviewing clues from some recent research, the NIH’s National Heart, Lung and Blood Institute highlighted why many women are at risk after misleadingly “clear” angiogram. In a study called the Women’s Ischemia Syndrome Evaluation, researchers have found that about two-thirds of women with chest pain pass an angiogram. But about half of them turn out to have a condition named “coronary microvascular syndrome,” where plaque evenly coats very small arteries instead of forming more obvious obstructions in larger ones.
Angiograms can’t see these tiny arteries, Dr. Sopko explained. The narrowed small arteries mean less oxygen flow to the heart, explaining the women’s chest pain.
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