18,000 of heart attack victims in Germany are women. Their risk of death is higher, also because they have different symptoms than men, which is why they are often treated incorrectly and too late. A cardiologist offers to help them and criticizes his ignorant colleagues.
For ten years Regina Wellmer thought there was something wrong with her. His heart often pounded, even when he climbed the stairs. He felt a tightness in his chest, stomach and back.
The sixty-year-old embarked on an odyssey of medical visits, but not even the cardiologist could find the cause, they even reacted with irritation, called her hysterical and did not take her complaints seriously. Regina Wellmer began to doubt herself: What if she was the problem? Instead of heart medications, she was prescribed psychotropic medications.
Worse and treated later
Regina Wellmer actually has a different name, but there are many stories like hers. The symptoms mentioned are signs of an impending heart attack, which could be prevented or, if necessary, treated quickly. However, studies show that women treated worse or later become like men.
And quite a few die because of it; 18,000 of the heart attack deaths in Germany each year are women. They are more likely to be misdiagnosed, and many are so confused by doctors that at some point they no longer trust themselves.
Cardiologist Michael Becker recognized the problem and then first in October 2018 Women’s Cardiac Center founded in Germany. The 53-year-old head doctor at the Rhein-Maas Clinic in Würselen specializes in women’s hearts. Every day around five women with heart problems come to him from all over Germany and abroad.
Regina Wellmer is one of 4,000 patients whose data has been recorded in her department. “Evaluations show that many women have similar complaints that are often misinterpreted,” says Becker. Its symptoms include stomach and back pain, which doctors are unlikely to notice.
Size is considered a decisive factor: a woman’s heart is smaller than a man’s, beats faster and pumps more blood. The heart of both sexes is supplied with blood by three vessels, which in men are more likely to
However, when women reach menopause, estrogen production decreases and the natural protection against vascular calcification disappears. In this regard, heart attacks in men occur on average around the age of 55, while in women about ten years later. Your heart responds to stress with a higher heart rate, which increases blood pressure. Women are also more often affected by arrhythmias.
Since women’s and men’s hearts are different, a heart attack manifests itself differently. While a man often feels excruciating pain in his left breast, a woman’s left arm or shoulder is more likely to hurt. Women also complain of gastrointestinal discomfort such as abdominal pain and nausea, but back pain or shortness of breath may also be signs. For them, the evidence of a heart attack is less clear.
Emergency doctors and paramedics don’t always recognize it right away. According to reports in 2023, the probability of dying after a heart attack is more than double for women compared to men Analyze of 884 cases shown. In the group of people up to 55 years of age, women took an average of 95 minutes to undergo surgery to widen narrowed coronary arteries after arriving at a clinic, for men it was almost 15 minutes less; Almost 12% of women did not survive the next month, only about 5% of men.
A General study Added to this bleak picture is the American Heart Association, according to which a woman is less likely to be resuscitated after a heart attack than a man. If you call 911 because of chest pain, you are less likely to be taken to hospital and are less likely to have an electrocardiogram or blood test.
Ten years since diagnosis
The German Heart Foundation points out that cardiovascular diseases in women are still underestimated. With over 180,000 deaths per year, these are the most common cause of death among women. “Even some doctors don’t realize that the risk of having a heart attack is just as high in postmenopausal women as it is in men,” Becker adds.
Most of his patients have gone through a long ordeal; on average, they wait a decade for a diagnosis and are examined by more than eight doctors before visiting the Women’s Heart Center. For some, the symptoms are explained by a psychological diagnosis, like Regina Wellmer.
Indeed, there are such cases; Cardiac neurosis, for example, is a psychiatric disease: those affected are falsely convinced that they suffer from a serious heart disease. They complain of symptoms such as palpitations or palpitations, but the physical causes cannot be identified.
But in most cases the problem is the heart. First, it’s important to “give women the feeling that they are understood and that their complaints are taken seriously,” Becker says. Take all previous results and treatment approaches, expand
One reason heart disease in women often goes undiagnosed or diagnosed too late is that doctors don’t know enough about it. On the one hand because in their training they learn almost nothing about the differences between the hearts of women and men, on the other because the research data is incomplete. Women are often severely underrepresented in large health studies.
He criticizes the fact that less than a third of the patients tested were women German Society of Cardiology. Therefore, gender-dependent disease characteristics, expression and symptoms have not been sufficiently studied. Becker reports, for example, that standard catheter tests are often not sufficient. If the cardiac vessels are not calcified, a possible lack of supply to the heart muscle is verified using a pharmacological test.
Hostility from colleagues
However, Becker has another explanation why many diagnoses are not made: social status. It is still believed that women are sensitive and panicky, says the cardiologist. If they complain of pain, it is minimized.
A study by Munich researchers funded by the Heart Foundation supports his description. According to this study, women over 65 with heart attack symptoms take an average of more than four and a half hours to go to the emergency room, while it takes an hour less for men of the same age.
Furthermore, it apparently makes a difference who you deal with. A current study from Japan in the specialized journal “Annals of internal medicine“Notes. When older women were treated in hospital by a female doctor instead of a doctor, the mortality rate for some diseases was slightly lower.
After the opening of the women’s cardiac clinic and the publication of the current one book “A Matter of the Heart – Why Women’s Hearts Beat Differently” (Hoffmann and Campe, 271 pages, 18 euros), Becker feels the displeasure of his colleagues.
The cardiologist was insulted and even denounced over the phone as doubtful, “just a publicity stunt” and as a traitor to medicine. “Many seasoned doctors rely on their knowledge,” Becker explains, unapologetically: Anyone who still claims today that there are no
Together with other doctors, she supports gender medicine and calls for gender differences to be included in the regular curriculum. Medical staff in surgeries and clinics must also be trained and made aware of this. The proportion of women in medical practices should be increased until the gender distribution matches that of the population.
But Becker also holds women responsible: instead of submitting and looking for the cause within themselves, they should get themselves medically examined at an early stage. And if necessary, they should contact emergency services - don’t let too much time pass.
She advises women who notice their heart is behaving differently to see a doctor they trust. A doctor who takes the time to research and listen to his patients, does not minimize their suffering and, if necessary, refers them to a specialist.
“Women often go through a cycle that lasts years: family doctor, pulmonologist, stomatologist, cardiologist, then all over again…” Becker says. Often it is just the reference to psychiatric drugs that gives the impetus to asking around and doing research on the Internet. That’s how Regina Wellmer ended up at the Women’s Heart Center. Since he started receiving the right medications, his symptoms have disappeared. And she can trust herself and her doctors again.
How can medical education be improved to address gender disparities in heart disease treatment?
Ed physicians find it difficult to accept new insights and changes in established practices,” Becker comments on the resistance he faces. This hostility, he believes, is partly due to the long-standing biases and stereotypes that persist within the medical community regarding women’s health issues.
The implications of these biases are severe, as they contribute to the underdiagnosis and undertreatment of heart conditions in women. Becker argues that it is essential for the medical community to recognize the unique aspects of women’s cardiovascular health and to tailor diagnosis and treatment approaches accordingly. There is a pressing need for more gender-specific research and training for healthcare professionals, ensuring that women receive the same level of urgency and care as men when presenting with symptoms of heart disease.
the disparities in the diagnosis and treatment of cardiac events in women highlight the need for a more nuanced understanding of cardiovascular health that considers gender differences. Addressing biases, enhancing medical education, and conducting more comprehensive research are critical steps toward improving outcomes for women with heart disease. With continued advocacy and awareness, it is hoped that the medical community will evolve to provide equitable healthcare for all patients, regardless of gender.