Experts propose a name change for women's heart disease

Heart disease in men is not the same as heart disease in women, say an influential group of cardiologists. Instead of referring to all heart disease by the medical terms of coronary artery disease or coronary heart disease, they argue that the term ischemic heart disease should be used to describe the illness experienced by women.

The paper, published today in the Journal of the American College of Cardiology, points out that the current focus of treatment for heart disease centers on obstructive coronary artery disease, which is when the arteries of the heart become clogged with plaque. However, women have less obstructive disease but higher rates of ischemia, which is defined as the inadequate flow of blood through the body because of constriction or blockage in blood vessels. Women with heart disease have more microvascular dysfunction -- affecting the small blood vessels of the body - compared with men.

Women tend to experience worse outcomes compared with men because the focus is on obstructive heart disease, the authors say, noting women have higher rates of sudden cardiac death before arriving at a hospital compared with men.

A name change may help doctors tailor diagnostic tests and treatments to better suit their patients, both men and women.

"Ischemic heart disease in women presents a unique and difficult challenge for clinicians due to a greater symptom burden, functional disability, greater healthcare needs, and more adverse outcomes as compared to men despite a lower prevalence and severity of anatomical coronary artery disease," they wrote. The authors represent the Women's Ischemia Syndrome Evaluation, a study group that includes Dr. C. Noel Bairey Merz, director of the Women's Heart Center at the Cedars-Sinai Heart Institute.

-- Shari Roan

Photo credit: Los Angeles Times

Comments

[Don]

My wife has microvascular heart disease. A hospital and its doctors were more than willing to bill$40,000 in the 36 hours after she reported her symptoms to them, most of it spent in an attempt to figure out a diagnosis.

Unfortunately, it is difficult to diagnose tiny blockages in small veins. Men more typically have larger blockages in larger veins, and those larger blockages can be imaged in noninvasive ways.

The failure to diagnose microvascular heart disease reflects society's lack of interest in the health of women? Come on, we as a society spend twice as much on health care for women as for men.

[Male_Matters]

The writer could use a different view:

"Women's Advocates Wrong About Why More Women Than Men Die of Heart Disease" at http://tinyurl.com/pkkajz.

[Jissy]

I understand that this is an important issue after going through the tragedy of losing my 38year old younger sister in March 2009. She did not have any previous history of heart disease . She had symptoms of chest discomfort on the day but her GP could not detect anything from ECG a few hours before the arrest. So he diagnosed it as acute stress disorder(her husband was traveling and kids were having school exams) and sent her home after giving her a pint of I/Vdextrose saline as she appeared dehydrated. She died of sudden cardiac arrest and pulmonary edema due to Ventricular Fibrillation during her sleep that night. Autopsy did not show any infarction or atherosclerotic changes. The only anatomical finding( which was revealed later) was 'narrowing of right Coronary artery lumen and right coronary ostium significantly'.

The only clue I have now is that she had an episode of varicella zoster(shingles) during her first pregnancy and had hypertension during her 2nd pregnancy. She appeared to be healthy,cheerful and fit when I met/stayed with her in our parents' house 2 months before the incident.

[Deena Lanham]

I agree that the name needs to be changed to Ischemic Heart Disease or Microvascular Heart disease in relation to women's health care. I have Microvascular Syndrome X and began having symptoms when I was 39 y/o. I had a angiogram and actually coded on the table. I feel like when I tell people what I have, they have no clue and they down play it.

[Sharon]

I think I have this, sometimes at night while I'm falling asleep, my heart races and stops. It seems to be caused by certain foods, goat cheese, Parmesan, sardines. It's horrible, and it seems to be getting worse in that, more foods seem to be causing it. I've been eating these foods for years.