En español l "I think I'm having a heart attack," Georgia Chapman said, to anyone who would listen. Two paramedics and an emergency room doctor told her no, she was fine — just a healthy 55-year-old stressed out from working two jobs. Go home and rest, they said.
Chapman wasn't buying it. "We are wasting time," she insisted, planting her feet. By the time the cardiologist saw her and rushed her into surgery, three of her heart's four arteries were completely blocked. One required a stent to restore blood flow.
Unfortunately, ordeals like Chapman's are not uncommon. Recent studies have found that if Georgia had been George, a man age 55, she likely would have been tested and treated immediately. "The number one reason women are misdiagnosed is that they aren't referred for testing," says Noel Bairey Merz, M.D., director of the Barbra Streisand Women's Heart Center at Cedars-Sinai Heart Institute in Los Angeles, and one of the world's leading experts on women's heart disease. "The doctor will say, 'You look good; it must be heartburn. It must be your gallbladder.' "
Every day more than 500 women in the U.S. die from coronary heart disease, due largely to ignorance. Despite increased attention and well-funded public-awareness campaigns (think Go Red for Women), 46 percent of women still don't know that heart disease is the nation's number one killer of women. Even doctors don't always recognize the symptoms. Indeed, women are seven times more likely than men to be misdiagnosed, according to the New England Journal of Medicine. If Bairey Merz gets what she wants — more research, more testing and better heart-health education — the death rate for women afflicted with heart disease and heart attacks could decline significantly.
"Nine million women die of cardiovascular disease every year worldwide," she says flatly. "If a virus came around and did a fraction of that …" She trails off, shaking her head. "It's mind-boggling. Heart disease is the most costly, the most preventable, the most deadly, yet we spend the least amount of money on screening."
As a young doctor, Bairey Merz, now 58, wondered why so many women with heart attack symptoms had no evidence of heart blockages — and why so many returned for medical care, often disabled or dying from heart attacks.
At that time, most doctors still believed heart problems were rare in women, especially those under 65. Nothing could be further from the truth. More U.S. women have died of cardiovascular disease than men in every one of the past 30 years. And since 1998, even as overall deaths from heart disease have been slashed by nearly a third, there is one glaring exception: Heart disease deaths in younger women — those who are under 55 — keep rising, according to the journal Global Heart.
Part of the problem is the medical establishment's failure to allocate research money to the disease. Every year, Bairey Merz notes, almost $675 million is spent on breast cancer research in the U.S., compared with about $173 million on research about women's heart disease, which kills five times as many women as breast cancer annually. "Women are more likely to be missed because of our failure to do research in women," Bairey Merz says. "We have to recognize that the last 70 years of heart research has been conducted in men, for men and by men, so we have knowledge gaps about what may work best in women."
While more research is clearly needed, Bairey Merz has immersed herself in the cause. She has some 200 research papers to her name, and her offices have become the de facto laboratory for women with persistent but undiagnosed cardiac symptoms. Such as the 34-year-old vegetarian mother of three, an avid runner, whose heart arteries were almost fully blocked, even though her doctors had told her all was well. Or the pediatric nurse reassured by 10 cardiologists that her debilitating chest pain was benign, before finally getting a correct diagnosis and effective treatment. Then there's the patient who had extensive dental work for her jaw pain before learning she had advanced heart disease.