Is heart disease in women being misdiagnosed as stress?

If you have chest pain, breathlessness or an irregular heartbeat, you'd expect your doctor to check you out for heart disease. But if you're a woman, it's possible that might not happen. Instead, you might be told your symptoms are caused by stress.

A study presented at a recent conference looked at decisions made by 230 experienced American physicians. The study showed that doctors were more likely to put these symptoms down to stress if a woman appeared anxious, or if they knew she had been through stressful events.

The researchers asked family doctors and internists to look at a set of notes about a patient, all of which had the same symptoms, suggesting heart disease. But in some notes, the patient was identified as a man, and in others as a woman.

When the notes also included information about the patient appearing anxious or having had a tough time recently, many of the doctors thought the women's symptoms were likely down to stress. Interestingly, they didn't think the same when the patient was a man. The physicians were far more likely to say they'd send a man to a cardiologist or start him on heart medication.

Could this be why women with heart disease are less likely to get diagnosed? It's a worrying thought. A delay in diagnosis could mean a delay in getting life-saving medications or other treatments to protect against a heart attack.

What you need to know. Symptoms that could be a sign of heart disease should always be checked out, whether you're a man or a woman. Don't be afraid to ask your doctor directly if you are worried that you might have a heart problem.

—Anna Sayburn, patient editor, BMJ Group

ConsumerReportsHealth.org has partnered with The BMJ Group to monitor the latest medical research and assess the evidence to help you decide which news you should use.

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Comments

[yvonne]

Hi,
Great site!!!!! Good health is very important with the high cost of medical coverage. We need to have a healther lifestyle by taking care of our health eating and exercising and also avoiding stress. I am a cancer survivor and I know. Our health is our greatest asset. Keep up the Good Work!!!!!

[Arnold Levi, Sr.]

Isn't stress a precursor for heart disease as well as a symptom thereof? Looks like somebody needs to be a little more thorough in their diagnostic evaluation. Hard to care for the patient and the hmo simultaneously.

[Jacqueline]

What makes me irritated about this study is how obvious it is that the medical establishment has very little concept of how emotions are related to the body's physical state. Okay, so the doctors focus in on stress -- these women probably are really stressed out, but why don't the doctors take it one step further to see what the stress is doing to the heart? There is a well documented connection between the two. See the link to an article from Women to Women dot com in my sig (a very respected clinic in Maine cofounded by Dr. Christiane Northrup).

[James Hubbard, M.D., M.P.H.]

Thanks for the information. Women with heart problems present with fatigue, dizziness, jaw or neck pain more than men.