Tuesday, February 14, 2006

Have a heart

The Boston Globe published some important women's health information yesterday, but my reaction to the article by Stephen Smith was so thoroughly mixed that it was difficult for me to figure out what to say about it.

The content was vitally important, especially for women like me who have a family history of heart conditions such as high blood pressure and diabetes. My grandmother died of congestive heart failure, to which her years of poorly managed high blood pressure certainly contributed. My mother is managing her blood pressure through meds, and, even more importantly, through exercise. About a year ago, my blood pressure was borderline high for the first time. So any information feels useful.

The presentation, however, left a lot to be desired.

First, though, the important part: women experience different heart disease symptoms than men do, and currently available tests do not necessarily show the problem.
Medical research published this month shows that as many as 3 million women in the United States suffer from a form of heart disease that hides from angiograms, which examine only the heart's three big arteries. That discovery is the product of a major study that aims to better understand the distinctive heart disease suffered by many women.


The landmark study that appeared this month in the Journal of the American College of Cardiology tracked 936 women with symptoms so concerning that doctors ordered an angiogram, an X-ray that's taken after dye is injected into the heart.

Only one-third of the women had significant blockages, while the rest appeared to have free-flowing arteries. But further tests showed that half of the women whose angiograms were clear actually had problems in other, smaller vessels that carry oxygen to the far reaches of the heart.
While this is good to know, the article was far from reassuring about the standard of care that women have been receiving from our cardiologists.
"In the past, those patients whose angiograms showed no big blockages would have been sent home and told you have no problem or it's in your head," said Dr. George Sopko, a cardiologist at the National Heart, Lung, and Blood Institute. "Now, instead of saying, 'Go home, don't worry about it,' the patient needs to be carefully looked at and provided a plan."
I am relieved to see that it is no longer acceptable to send patients home with a pat on the head. (Seriously, is this new? Because that would depress the crap out of me.) I can't help but wonder if this is one reason why it took 22 years, years of heart disease being the leading killer of women, for this kind of information to come to light.

What really bothered me, though, was the cutsey and even mocking tone of the article.

When I first saw the title, "The secrets of a woman's heart," I rolled my eyes. I would have bypassed the article, writing it off as some kind of V-Day tripe, but for a subtitle that indicated it's actual content. Perhaps it was someone's idea of a witty pun for this time of year, but it didn't work for me.

I didn't exactly fall over laughing when I read this, either:
When it comes to affairs of the heart, women really are different from men: They're much more likely to have trouble with the avenues and alleys that branch off from the major highways of the heart. And problems in those smaller vessels can't be detected by conventional methods.
How poetic, referring to a deadly heart condition as a romantic escapade of some kind. I can tell you really care. "See ladies? You really are different from men, and it comes with undetectable heart disease!" Hardy har har.

Smith just can't resist closing with another zinger of this kind. At the beginning of the article, he write about a woman with heart problems for whom the traditional diagnostic tools were not effective. Toward the end, he reassures us that she is now receiving care, and has a heart scan scheduled.
Maybe, she said, it will help answer why, every other month, her heart betrays her.
Betraying her, indeed.


Blogger Ellie Finlay said...

My mother suffered from congestive heart failure for years before it finally killed her. When she first had symptoms, she sought medical help and was told it was all in her head. By the time she was properly diagnosed she had already suffered severe damage to her heart. The worst part for her was the constant indignity of having her experience invalidated by doctors and being patronized by them.

11:04 AM  
Blogger Gyratory Circus said...

My grandmother had a heart attack and it took *over a month* for it to be diagnosed because she wasn't having "typical" symptoms. Fuckers.

12:15 PM  
Blogger hybrid said...

Ellie, my grandmother's story is so similar. When her breathing started to become labored, a common symptom of heart failure, she was diagnosed with asthma. And sent home with an inhaler.

I'm with GC. Fuckers.

1:48 PM  
Blogger Sass said...

You know, the "atypical symptoms" thing really bugs me. If more women than men die of heart disease, how on earth can women's presentation of symptoms be atypical, and how can women's signs of heart disease be "different" or "distinctive" from the norm?

1:01 PM  

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