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Diagnostic Confidence Key for Prompt Treatment
for Women With Heart Symptoms

By Sharyn Alden, Contributing Writer
Health Behavior News Service

WASHINGTON, DC, August 29, 2012 — Doctors who believe that women have “atypical” coronary heart disease symptoms are less certain when diagnosing heart disease in women. As a result, women are less likely than men to receive treatments for an urgent cardiac event, finds a new study in the Journal of Health and Social Behavior.

“Some physicians with lower diagnostic certainty were less likely to order medications and tests appropriate for an urgent cardiac situation, which opens the possibility for delayed care or poorer outcomes for women who present with the same coronary heath disease symptoms as men,” said Lisa C. Welch, lead author and director of the Center for Qualitative Research at the New England Research Institutes.

Welch said that framing heart disease symptoms that appear in women as “atypical” in comparison to symptoms commonly observed in men lowers diagnostic certainty for some physicians. “This finding was unexpected because efforts in recent years to incorporate women in the knowledge base for cardiac disease were intended to facilitate timely, optimal treatment.”

In the study, 256 primary care physicians watched one of 16 videos of male and female patient-actors of varied ages, race, and socio-economic status exhibiting the same cardiac symptoms. The doctors then discussed possible diagnoses and treatment plans. Though physicians considered coronary heart disease for both male and female patients, they were more likely to describe women’s symptoms as “atypical”, “non-specific” or “vague”. As a result, the physicians suggested attending foremost to cardiac concerns less often for women than for men.

Donna Arnett, Ph.D., president of the American Heart Association and Professor and Chair of Epidemiology at the University of Alabama, Birmingham, said, “What interested me was that gender doesn’t appear to be as much of an issue in this research as is certainty—how some doctors make decisions based on symptoms which they feel certain are representative of heart disease.”

Arnett added, “But decisions based on popular knowledge of what constitutes atypical cardiac symptoms can have unintended, misguided consequences. Sweeping generalizations about symptoms of heart disease cannot be made because women present with a full range of signs and symptoms including those that are considered typical in both men and women.”  

TERMS OF USE: This story is protected by copyright. When reproducing any material, including interview excerpts, attribution to the Health Behavior News Service, part of the Center for Advancing Health, is required. While the information provided in this news story is from the latest peer-reviewed research, it is not intended to provide medical advice or treatment recommendations. For medical questions or concerns, please consult a health care provider.

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About the American Sociological Association and the Journal of Health and Social Behavior
The American Sociological Association (www.asanet.org), founded in 1905, is a non-profit membership association dedicated to serving sociologists in their work, advancing sociology as a science and profession, and promoting the contributions to and use of sociology by society. The Journal of Health and Social Behavior is a quarterly, peer-reviewed journal of the ASA.

The research article described above is available by request for members of the media. For a copy of the full study, contact Daniel Fowler, ASA’s Media Relations and Public Affairs Officer, at (202) 527-7885 or pubinfo@asanet.org.

The Health Behavior News Service, part of the Center for Advancing Health, can be reached at (202) 387-2829 or hbns-editor@cfah.org.


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