Most M.D.s unaware of differences in heart disease in men and women

Most M.D.s unaware of differences in heart disease in men and women

Gallup survey results called "alarming"

Results from a national Gallup survey found nearly two-thirds of the nation's primary care physicians inaccurately reported "no difference" in the symptoms, warning signs and diagnosis of heart disease in women, compared to men.

The survey, commissioned by Washington Hospital Center, asked 256 internists and family practitioners across the country to determine medical doctors' awareness of the prevalence, severity and signs of heart disease in women.

"If a physician follows the classic male model for diagnosing heart disease, a huge number of women with heart disease will be missed," said Washington Hospital Center cardiologist Patricia Davidson, M.D. "Both women and their physicians must be aware that the symptoms of women's heart disease are different from men's."

Heart disease is the leading cause of death among American women, each year claiming 233,000 lives -- six times the number of women who die of breast cancer annually.

Prevalence of the disease among women is also high. Each year, 625,000 women suffer a heart attack. Over 28 million American women are living with the effects of cardiovascular disease, including heart disease, high blood pressure and stroke. Of these, more than one-half are under the age of 65.

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While angina (chest pain) is a major indicator of heart disease in both women and men, other symptoms in women, such as shortness of breath and chronic fatigue, are very common and are often being ignored.

Although two-out-of-three physicians surveyed identified shortness of breath as a warning sign of heart disease in women, chronic fatigue was listed by fewer than one-out-of-five respondents and only 10% mentioned other important symptoms for women, including nausea, dizziness or swelling of the ankles.

In addition, the Gallup survey found that:

- Only 39% of the doctors had extensive medical training in diagnosing heart disease in women, compared to 69% who said they had extensive training in diagnosing the same disease in men.

- 68% said there is no difference in diagnostic tests for men and women, when in actuality heart disease can be diagnosed more effectively and accurately in women using a nuclear stress test or stress echocardiogram, rather than a simple treadmill electrocardiogram (ECG), commonly called a stress test.

- Half of those surveyed listed a health problem other than heart disease as the greatest health risk facing women over 50. Breast cancer was listed by 18% and 10% said osteoporosis. Yet, twice as many women die of cardiovascular disease each year than die of all forms of cancer combined.

SOURCE: "Majority of primary care physicians unaware of differences in heart disease In men and women; many cases of heart disease in women undiagnosed," Center for Cardiovascular Education, Nov. 21, 1996.

The Chiropractic Journal.

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