Robb Report: Why Women Aren't Getting the Care They Need

Robb Report journalist Lisa Sweetingham recently interviewed a Smidt Heart Institute cardiologist and one of her patients about why women with heart disease often face problems getting properly diagnosed and treated. Many studies have shown that women are particularly vulnerable to receiving suboptimal treatment by their healthcare providers simply because some providers are not aware that heart disease symptoms in women are often different than what male patients experience.

When Barbara Fleeman felt some sharp chest pains, she told Robb Report journalist she checked herself into the emergency room of a local hospital, only to be told by the doctor that she was likely had a case of indigestion or chest pain.

“I felt totally ignored,” Fleeman told Robb Report. “He didn’t get it. Something was very wrong with me, and I knew it was in my heart—not my head.”

Undeterred, she called Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center in Cedars-Sinai’s Smidt Heart Institute. Bairey Merz is the principal investigator of the Women’s Ischemia Syndrome Evaluation study, an ongoing multicenter study sponsored by the National Heart, Lung, and Blood Institute that is changing the way physicians approach heart disease in women.

Merz ordered a high-resolution stress cardiac MRI for Fleeman, which provided a more detailed look into her heart, and found that she had coronary microvascular dysfunction, a type of heart condition in which the tiniest arteries in the body are damaged. Men with heart disease are more likely to develop clogs in the larger arteries of the heart.

Sweetingham notes that while Fleeman lives in a major metropolis and was able to secure an accomplished female cardiologist, not everyone is so lucky; men still dominate the field and coronary microvascular dysfunction is still not recognized. Despite this, Bairey Merz told the Sweetingham that she and her colleagues are seeing an increased interest and awareness among the next generation of cardiologists.

“The physicians in training now tell us that they want more education about sex and gender differences,” she said.

“I do think that the younger ones will lead the change. But how quickly? I don’t know. Fifteen years ago, when we’d present our findings at the annual American Heart Association meeting, there would be 30 people in the audience for our session. Now it’s 500. In the big picture, 500 out of 30,000 attendees is still a minority. But it’s a start.”

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