Two-thirds of primary care doctors in the Baltimore area don't know the sometimes subtle symptoms of heart disease in women, according to a new Gallup survey to be released today. .
Only a third of the physicians correctly identified some of the most significant signs of heart disease in women, such as chronic fatigue, dizziness and nausea.
The survey, commissioned by Union Memorial Hospital, found that about 80 percent of doctors cited crushing chest pain as a major warning sign, for example, when this symptom is more common in men.
Across the country, the lack of awareness among physicians of the gender differences in heart disease has devastating consequences. Experts say the disease in many women isn't diagnosed until they are very ill; others are wrongly sent home from emergency rooms, only to have heart attacks later and die.
"It really is a huge public health issue, and I think that it's not only the physicians that may not understand the importance of this, but the women themselves and their families," said Dr. Michael Rubinstein, director of the Women's Heart Disease Initiative at Union Memorial.
As a response to the survey findings, Union Memorial and other hospitals in the MedStar Health network are launching an education campaign. The American Heart Association and other organizations have conducted similar efforts to alert patients and physicians to signs of the disease.
Heart disease is the leading killer of men and women. One in three women dies from heart disease and stroke, more than twice as many as die from all cancers combined.
Vague, innocuous
But women have different symptoms than men -- symptoms that can seem vague and innocuous -- so many physicians don't think of heart disease when a female patient complains of lightheadedness or nausea. To make matters worse, some of the standard diagnostic tests for identifying heart disease are not as accurate in women as they are in men, doctors say.
Rubinstein noted that about 70 percent of primary care doctors didn't know that some diagnostic tests, such as a stress echocardiogram, are more sensitive and specific to women. Also, about 45 percent of the physicians interviewed said the greatest health risk for women over 50 wasn't heart disease. Instead, they named conditions such as breast cancer, osteoporosis and AIDS.
