Artery Heart Disease is Different in Women | The Doctor Weighs In

By: William H. Bestermann, Jr., M.D.

There is no better example of the disconnect between what we know and what we do than in the case of women with heart artery disease.

The specific research around the ways heart artery disease is different in women has been done. It is landmark research that has life or death implications. There are dozens of scientific articles1 that address this topic.

Differing Symptom Patterns

In all American medicine, there is no better example of the disconnect between what we know and what we do than in the case of women with heart artery disease. While the different symptom patterns in women with abnormal heart arteries are receiving more attention, a failure to translate those best-practice treatments makes their lives more dangerous and expensive. The woman who is seen in the emergency room for chest pain or other symptoms suggestive of coronary disease will be evaluated under an outdated scientific paradigm aimed at finding blocked arteries. She will have a stress test done and /or cardiac catheterization. If these tests are normal, the patient will be told that the symptoms are not related to her heart. I saw patients who had repeated chest pain and had been told that the problem was her esophagus or worse depression. She was told in effect: “Go home, take your Valium and Prozac, you will be fine!” What she has been told is wrong-too often dead wrong!

The American taxpayer has already paid for a specific study looking at the unique nature of coronary artery disease in women. The findings of the NIH-sponsored WISE study2 (women’s ischemic syndrome evaluation) study are extremely important and have very practical implications.

Gender Differences

Coronary artery disease in women is different from coronary disease in men. This illness in men produces local arterial blockages that cause chest pain with exercise that is relieved by rest. Many women produce cholesterol deposits that are distributed evenly throughout the arterial system producing arteries that are small and with less localized blockage. Still, these deposits can rupture and produce clots. Most heart attacks are clotting events, which explains…