Dr. Sarrel shares some reasons why more women than men may be dying from heart attacks.
Why do more women die of heart attacks each year than men? One answer of course is by the time you get into the elderly age group there are more women than men; the men have died off already. So as women now live longer, into their 80s and 90s, it is true that the number of deaths per 100,000 women, by the time you get into that 80 to 90 age group it skyrockets.
So that’s one part of the explanation but there’s another reason that’s very important. Women who have a heart attack who get hospitalized for treatment much more often than men, at least twice as often compared to men, are actually having their second heart attack. The first heart attack was missed.
So the heart has already been damaged. It was missed either because it was a silent heart attack, without symptoms or just a kind of funny feeling and the women walk through it and that’s a very real phenomena, which is why regular checkups are important, or they were seen and sent away, and then went home and had their heart attack and survived and now they are coming back for the second time around.
So, in fact, with the second heart attack, it’s occurring in an already damaged heart. So no surprise their mortality rate is greater than men who are admitted to hospital because men typically are admitted with their first heart attack. That’s an important reason.
It’s also true that the procedures that are done to evaluate a male with chest pain are very different than what happens to a woman with chest pain. A man will go through an exercise test, who have a magnetic resonance imaging to see a heart, blood flow is occurring, goes through a whole battery of things. Women typically don’t have that done.
So, we know that the awareness of the problem in women affects the quality of the evaluation and of course, the treatment and the preventive medicine that occurs. I think those are some of the important issues that would explain why there is a difference.
About Dr. Sarrel, M.D.:
Philip M. Sarrel, M.D., completed his medical education at New York University School of Medicine, his internship at the Mount Sinai Hospital, and his residency at Yale New Haven Hospital. In addition to his many years on the faculty of the Departments of Obstetrics and Gynecology and Psychiatry at Yale University School of Medicine, Dr. Sarrel has also been a Faculty Scholar in the department of psychiatry at Oxford University, Visiting Senior Lecturer at King’s College Hospital Medical School at the University of London, Visiting Professor in Cardiac Medicine at the National Heart and Lung Institute in London, and Visiting Professor in the Department of Medicine at Columbia University College of Physicians and Surgeons in New York. He is currently Emeritus Professor of obstetrics, gynecology, and psychiatry at Yale University.