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Cardiac Problems and Conditions That Especially Affect Women

It's Not Just 'Anxiety'

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Updated November 12, 2011

Heart disease is at least as important in women as it is in men. But in addition to the more classic forms of heart disease, there are certain "other" cardiovascular conditions that are seen predominantly in women, and which, unfortunately, are often mishandled by physicians.

The most prominent cardiac conditions affecting women, of course, are coronary artery disease and heart failure. While these are also the most prominent cardiac conditions seen in men, they often "behave" quite differently in women, which may lead to confusion (on the part of both women and their doctors), and to inappropriate treatment.

Several less classic cardiovascular conditions predominantly affect women, and often produce problems in two distinct ways. First, the conditions themselves can cause significant symptoms. Second, doctors all too often write these symptoms off as being caused by "anxiety," when in fact they are caused by real medical problems. So not only do the women who have one of these conditions suffer from the condition itself, they may also suffer from being inappropriately labeled as having a psychiatric problem.

If you have any of these conditions, the first step in getting the help you really need is to learn as much as you can about the condition. If nothing else, this will help you to determine whether your doctor is approaching your problem with the respect, and the expertise, it deserves.

Dysautonomias

Dysautonomias are a family of disorders that can produce symptoms involving almost any organ system in the body. Cardiac symptoms include chest pain, palpitations, dizziness and syncope (fainting). It is very common for women (and men) who suffer from one of the dysautonomias to be labeled as being "anxious" (or otherwise crazy) by one or two doctors before finding a physician who makes the correct diagnosis.

Palpitations

Palpitations, or an unusual awareness of the heart beat, is often manifested by the feeling that your heart is racing, or skipping beats. The key to treating palpitations is making the correct diagnosis - that is, "capturing" one of the episodes of palpitations on an electrocardiogram (ECG). While it is not rocket science to accomplish this feat, far too many doctors drop the ball. So if you have palpitations, you should apprise yourself on what your doctor really ought to be doing to get to the bottom of your problem.

Inappropriate Sinus Tachycardia

Inappropriate sinus tachycardia (IST) is most likely a form of dysautonomia characterized by an inappropriately high heart rate and palpitations. Just as in the other dysautonomias, IST is often misdiagosed as "anxiety."

Mitral Valve Prolapse

Unlike the cardiovascular conditions listed above, mitral valve prolapse (MVP) is diagnosed far too often, and is blamed for many things it does not cause. While in some women (who are readily identifiable by echocardiogram) MVP can cause significant cardiac valve dysfunction, most of the time MVP is a trivial cardiac finding that is blamed inappropriately for a host of symptoms that are almost certainly due to dysautonomia.

Sources:

Furlan R, Barbic F, Casella F, et al.Neural autonomic control in orthostatic intolerance.Respir Physiol Neurobiol. 2009 Oct;169 Suppl 1:S17-20.

Zimetbaum, P, Josephson, ME. Evaluation of patients with palpitations. N Engl J Med 1998; 338:1369.

Kim, S, Kuroda, T, Nishinaga, M, et al. Relation between severity of mitral regurgitation and prognosis of mitral valve prolapse: Echocardiographic follow-up study. Am Heart J 1996; 132:348.

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