Tests Miss Clogs in Women
WASHINGTON – Conventional tests won’t uncover heart disease in as many as 3 million U.S. women – because instead of the usual bulky clogs in main arteries, these women have a hard-to-spot buildup in smaller blood vessels, researchers said Tuesday.
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’re actually at high risk for a heart attack 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 Institutes 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 some disturbing 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 than men to different risk factors and therapies. They frequently have different symptoms of a heart attack than men do, such as fatigue instead of the classic 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 for men.
On Tuesday, reviewing clues from some recent research, the NIH’s National Heart, Lung and Blood Institute highlighted why – and how many women are at risk after a misleadingly “clear” angiogram.
In an ongoing study called WISE, 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,” in which plaque evenly coats very small arteries instead of forming more obvious obstructions in larger ones.