Underdiagnosis puts women at higher risk of dying from heart disease – Journal

KARACHI: One in four middle-aged adults in Pakistan lives with cardiovascular disease. Although men and women are equally likely to develop heart disease – the leading cause of death in the country – the risk of dying or becoming seriously ill from heart disease is vastly underestimated among women due to under-diagnosis and under-treatment.

So said the speakers at the 2nd Annual Heart Health Pulse Conference 2021 held at the Aga Khan University (AKU).

Speakers noted that contrary to the belief that heart disease only affects men, women are also at risk.

In fact, they pointed out, they faced gender-specific risk factors related to early onset of menstruation, menopause, and pregnancy-related complications such as preeclampsia.

Women with diabetes were also more likely to die from cardiovascular disease than men with diabetes.

“Gender is important in the manifestation of heart disease,” said Dr. Saira Bukhari, assistant professor of cardiology in AKU’s Department of Medicine. “Awareness of the differences in clinical presentation of heart disease in men and women is key to addressing the disease burden in the country.”

AKU’s annual Cardiovascular Conference is informed about gender issues in the manifestation of heart disease

Women, experts say, often report atypical heart symptoms. Clinical diagnosis of heart disease can be difficult as it may present with atypical manifestations of angina such as shortness of breath, weakness, fainting, nausea, and non-coronary chest pain syndrome.

Speakers added that women did not always recognize their symptoms as those of heart disease or generally delayed seeking medical help because of cultural barriers that restricted women’s access to health facilities.

Women tend to show up late to hospitals, increasing their risk of heart failure and subsequent death, they added.

60 female cardiologists in the country

“In addition to late presentation, treatment in women is less aggressive, leading to poorer outcomes,” said Professor Zainab Samad, chair of AKU’s Department of Medicine.

“Men and women may also have different preferences for their clinical care, and this has implications from the configuration of facilities to who provides clinical care. This is why it is important to have a gender perspective on the diagnosis and management of cardiovascular disease across the continuum of care,” she said.

Speakers noted that there was also a shortage of trained female cardiologists. There were only 60 female cardiologists in a country where almost 30% of all deaths are due to cardiovascular disease.

They pointed out that a lack of awareness of heart disease among women at various levels of the health care system as well as a shortage of female specialists were hurting patients seeking timely care.

The conference was organized in collaboration between the Section of Cardiology and the Department of Medicine at AKU Medical College and was endorsed by the Scientific Council for Women’s Heart Diseases under the Pakistan Cardiac Society and Pakistan Hypertension League.

Posted in Dawn, January 27, 2021