We have long heard that heart disease is harder to detect in women, that women are underdiagnosed and treated for this disease, that women are different.
It is emerging that indeed they are, and this story focuses on the fact that the difference may be in how the sexes store fat. Just as a man tends to store his around the middle where a woman would spread it all over (generalization, I know, but often the case), so do they deposit fate and cholesterol in their arteries.
Where men with chest pain go through the tests: ECG, stress test, cardiac catheterization, women are more likely to have a non-diagnostic stress test, but if they go for catheterization, it is less likely that they will have the discreet lesions more commonly seen in men. This is because they distribute the cholesterol more or less uniformly along the artery, so that when dye is injected into the vessel, there appear to be no narrowings...the whole thing is narrowed. The discreet, specific narrowings that are treatable with angioplasty or bypass are not seen, and the women are often told they have no disease.
Another issue is that women have more disease of their small coronary vessels--again less visible and treatable--than do men. Thus the disease in women is more responsive to diet, exercise and medication than to high-tech procedures and surgery.
The good news is that the treatment does not involve splitting your chest. The bad news is that small vessels occlude more easily.
This link takes you to the NPR story.
This issue was also discussed in February on "All Things Considered", highlighting "hidden" heart disease in women, and the fact that many women are given a clean bill of health, only to go on and have a heart attack. Dr. Noel Bairey Merz talks about this phenomenon and W.I.S.E., the Women's Ischemia Syndrome Evaluation study.
[Artery photo from the NPR story.]