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Heart disease often misdiagnosed in women

By Elizabeth Cohen
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(CNN) -- When Jean Horgan complained of heart palpitations, her doctor told her it was just nerves.

"I was told, 'Go home and take tranquilizers. You'll be fine, you're under stress.' "

Much later, another doctor -- one specializing in women's health -- ordered an echocardiogram, an ultrasound test of her heart. The echo showed Horgan had a heart condition, and she needed medication.

When Phyllis Cruz went to the emergency room, she told the nurse she felt as if she was having a heart attack. She said the nurse didn't believe her.

"I said to her, 'But I have pain, chest pain. I can't breathe.' She said, 'Well, there's a lot of people here. Sit down.' "

Six hours later, Cruz also was given an EKG. It turned out she did have a heart attack.

Eventually Cruz turned to Nieca Goldberg, a New York cardiologist who specializes in women. Her patients' biggest complaint is that their doctors haven't taken them seriously.

"And you know what? Most of the time they're right," said Goldberg, author of "The Women's Healthy Heart Program."

Statistics bear Goldberg out. "Research shows that women may not be diagnosed or treated as aggressively as men," says the Agency for Healthcare Research and Quality, part of the U.S. Department of Health and Human Services.

For example, even though more women than men die of heart disease each year, women receive 33 percent of all angioplasties, stents and bypass surgeries; 28 percent of implantable defibrillators; and 36 percent of open-heart surgeries, according to the National Coalition for Women with Heart Disease.

These figures may help explain why 75 percent of men survive a first heart attack, while only 62 percent of women do, according to the American Heart Association.

The National Institutes of Health and other groups aim to change these statistics by raising awareness with events such as Friday's National Wear Red Day.

They'll be calling for more research on women and heart disease, since about 25 percent of subjects in cardiac studies are female. And according to a new report from the Mayo Clinic, most of these studies don't segregate statistics by gender, so it's hard to learn much about women and heart disease. That's a key factor because the disease acts differently in men from the way it does in women.

First lady Laura Bush, an ambassador for the National Institutes of Health's heart awareness program, is scheduled to take part Friday in the fifth annual Red Dress Collection fashion show in New York. A part of Mercedes-Benz Fashion Week, the event brings out celebrity models in red dresses from American designers.

Much of National Wear Red Day's purpose is to change attitudes. The event seems to be making some inroads. According to a 2005 survey, 55 percent of American women were aware that heart disease is the leading killer of women, up from 34 percent in 2000.

But the question remains: Are doctors changing?

Goldberg recalled that when she was in medical school, "They showed us a picture of the typical patient with heart disease, and it was a middle-aged businessman, clutching his chest."

Perhaps now medical students will see a photo of a woman in a red dress.

Laura Bush at Friday's Red Dress fashion show, which marked National Wear Red Day for women's heart disease.


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