By Jill Filipovic
Thursday, February 13, 2003
Women heart patients are overwhelmingly dissatisfied with the care they get from their doctors. One big problem: Physicians aren't educated enough about what heart disease does to women.
(WOMENSENEWS)--Many women with heart disease found that their physicians were rude, condescending, abrupt or inattentive. Others said their doctors lacked knowledge about heart disease in women, according to a survey in the January/February edition of the medical journal Women's Health Issues.
The study found that 52 percent of women patients were dissatisfied with some feature of their medical care; 58 percent said their doctors didn't communicate clearly or lacked female-specific knowledge about heart disease. Still others were dissatisfied because of missed or delayed diagnoses and some complained that they didn't get useful information about their disease.
"Many of the women in the survey said they had wonderful physicians and they had a great interaction," says Dr. Sharonne Hayes, director of the Mayo Clinic Women’s Heart Clinic and lead author of the survey. "Over 75 percent of women actually felt like their physicians, both their cardiologist and their general practitioner, listened to them, responded to them appropriately, and worked with them. But I think we still need to highlight the fact that there's room to improve."
The study is the first-ever national assessment of female heart patients' experiences and thoughts about the disease. WomenHeart, a nonprofit, national coalition for women with heart disease, sponsored the telephone survey of 204 women who reported being diagnosed with heart disease. The women were asked a variety of open-ended questions covering many aspects of their disease, including the effects of heart disease on their lifestyle, satisfaction with the care they received, and awareness of risks and symptoms.
"The goal of the survey was to . . . look at this unique group of women with heart disease who had never been surveyed or asked before, to get an idea about their experiences with their disease, with their diagnosis, with the healthcare system and what kind of affect the diagnosis of heart disease had on their lives," Hayes says.
The most common heart disease was coronary artery disease, which is caused by the accumulation of plaque deposits in the arteries. It is treatable if caught early, but can lead to a heart attack if it goes unnoticed.
Symptoms of heart disease, including coronary artery disease, are chest pain, shortness of breath and weakness. Although 92 percent of women reported experiencing one or more symptoms, only 35 percent of women were able to correctly identify their symptoms as possibly related to their heart before being diagnosed.
However, 68 percent reported that their physicians correctly classified their symptoms as potentially heart-related.
Cindy DeMarco, a 32-year-old marathon runner and heart attack survivor, says she was misdiagnosed in the emergency room.
"No one in the ER believed I was having a heart attack," DeMarco says. "They almost sent me home, but I demanded an EKG," she added, referring to the diagnostic electro-cardiogram.
The risk factors for heart disease include smoking, diabetes, high blood pressure, high cholesterol, physical inactivity, being overweight and a family history of the disease. Almost half of the women surveyed did not perceive themselves to be at risk and their diagnoses came as a "complete surprise."
Few women recognize that cardiovascular disease, which includes heart disease, heart attack and stroke, is an immense threat, killing more U.S. women each year than all types of cancer combined. Only 8 percent of female respondents said their biggest health concerns were heart disease and stroke, according to a recent American Heart Association study of more than 1,000 women. Most women in that survey cited breast cancer as a more serious worry, despite the fact that heart disease takes the lives of more than 10 times as many women annually. Of those surveyed, 67 percent did not know that heart disease is the leading cause of death in women.
Women "need to be educated about heart disease," DeMarco says. "The best thing to do is to learn about early detection and to exercise. Getting screened and having your blood pressure checked is crucial."
After their diagnosis, only 14 percent of the women surveyed by WomenHeart reported making doctor-recommended changes in their diet or physical activity.
Many reported they experienced a change in "life perspective or outlook," and 10 percent reported no change in their life since the diagnosis.
According to Hayes, some women may be unable to make lifestyle changes because of mental health problems connected to their diagnosis.
"Over 50 percent of the women reported that they suffered from some type of mental illness related to their heart disease diagnosis," Hayes says. "Most of them were depressed or anxious or both. If you are depressed, you are unlikely to be able to make the lifestyle changes that you need to prevent another heart attack. If you feel so bad that you can't exercise or eat right, then you are more likely to have another heart attack."
Hayes hopes the WomenHeart survey will lead to further investigation of the various issues surrounding women with heart disease.
"These are fixable problems, potentially," Hayes says. "I think that's one of the things that this survey brings to light. Now we need to start working towards how we might make the interaction between the physician and the woman better."
Jill Filipovic is a Women's Enews intern.
WomenHeart: the National Coalition for Women with Heart Disease:
American Heart Association--
"A Study of Women's Awareness of and Attitudes
Towards Heart Disease and Stroke":
Jacobs Institute of Women's Health--Women’s Health Issues: