Exercise testing can reveal how well blood is flowing to the heart. Overall, men are more likely to have reduced blood flow, called ischemia. But women with anxiety disorders, including generalized anxiety as well as panic disorder, are more prone to myocardial ischemia. This could lead to a woman’s heart attack.
Symptoms of Ischemia:
When this blood flow to the heart is restricted, people may experience chest pain, neck or jaw pain or shortness of breath. Ischemia does not always cause symptoms, however.
Women and Ischemia:
In a study conducted in Montreal, Quebec, Canada, 2,342 patients went through exercise stress testing and a thorough assessment of mood and anxiety disorders. While anxiety had no effect on men’s heart function, women with anxiety were more likely to have ischemia.
Why This Matters:
The symptoms of a woman’s heart attack could be mistaken for an anxiety attack and lead to a diagnostic delay or failure, according to the researchers.
Circulation: Cardiovascular Quality and Outcomes, online Feb. 23, 2016
Women and Emotional Stress:
This is not the first time researchers have found a clear link between women’s psychological state and the conditions of their hearts. The Myocardial Infarction and Mental Stress Study (MIMS) also found that women under emotional stress are more likely than men to suffer myocardial ischemia. Often, these women are younger than typical heart attack victims (under 50 years old) and their stressors are difficult to alter: poverty, domestic violence or insecurity, depression or a history of abuse.
To learn more about the MIMS research, be sure to tune in to The People’s Pharmacy Show 1026: What Should Women Do to Protect Their Heart Health? One of the guests, Dr. Viola Vaccarino, is the lead investigator for MIMS.
Misdiagnosing a Woman’s Heart Attack:
One of Dr. Vaccarino’s earlier research reports demonstrates that women are more likely to show up at the emergency department without chest pain. A woman’s heart attack is more likely to be misdiagnosed partly on that basis. In addition, women are more likely to die from a heart attack. That is particularly true for a younger woman whose heart attack did not cause chest pain (JAMA, Feb. 22/29, 2012).
