Healthcast 604 - Women, and Black Men and Women, Wait Longer at the ER for Diagnosis and Treatment of a Heart Attack.

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Sexism and bigotry are still alive and well in medicine. I have experienced this often during my 40 years in medicine. Women are considered hysterical to the medical man (and some women) which has been what men think about us since time began. This has passed it's "sell-by" date, as has the bigotry against people of color, but it is present, and we must somehow get what we need and get around the attitudes of medical personnel.

My best advice is to not act hysterical because the male brain then flips to the thought that we are imagining this medical symptom! But if you cannot help it then have someone with you who can talk like a man---"just the facts", don't embellish and don't give them a long story…they lose interest, and forget why you are there.

Tell the ER Doctors and EMTs"

1. That you think you or your loved one is having a heart attack
2. The estimated time you started having these symptoms
3. If you took an aspirin, then tell them
4. Have your medical history written on your iPhone app: look up this icon on any iPhone
5. Have a list on the iPhone app or on a list in your wallet.
6. Give all this information to your healthcare provider right away.
7. Answer questions succinctly and quickly…no stories!

We are successful at treating heart attacks and preventing disability and death in older men, but women of all ages and people of color, both sexes, are not being treated optimally, certainly not as well as their older white male counterparts.

"Despite a decline in the number of overall heart attacks, this number is rising among young adults," Dr. Banco adds. "And young women and young Black adults have poorer outcomes after a heart attack compared to men and white adults."

Journal of the American Heart Association: symptoms of heart attack

• Chest pain, pressure, chest tightness, burning in the chest
• Shortness of breath
• Left arm pain,
• Jaw pain
• Upper back pain
• Heart burn
• Passing out

As doctors, we have been taught that women have different symptoms than men when having a heart attack, AND we have been taught that men have many more heart attacks than women. Only half of that is true. Women have fewer heart attacks when they are compared to young men of the same age, BUT women reach the same rate of heart attacks as men after menopause and if they are not replaced with estrogen. Our female patients at Biobalance Health actually have fewer heart attacks than is normal for their age after menopause because they are replaced with estradiol pellets.

Young adults 18 to 55 years old who come to the emergency room with chest pain may wait longer and get less thorough workups when they're female or Black, a new study suggests. But they have fewer heart attacks than men and women as they age.

The studies show that the care women receive is biased and are not considered at risk for heart attacks. An expert Gulati say in Everyday health,

"There is implicit bias in how we care for women," Gulati says. "Women are still not seen to be at risk for heart disease (https://www.everydayhealth.com/heart-disease/). It is still seen as a man's disease, despite the fact that cardiovascular disease remains the leading cause of death in both men and women."

Delay in treatment should not be discounted. It can mean the difference between life and death and health and disability.

"Time is heart muscle," Dr. Gulati says. "So, these noted delays and less aggressive care of women have the potential to translate into delays in care, less diagnostic testing, deaths at home for some discharged, and continued worse outcomes after a heart attack in young women — particularly young Black women."

If you have the symptoms of a heart attack, you should take a baby aspirin (81 mg) and call 911. Time is obviously very important to the heart and lack of oxygen from a heart attack damages the heart muscle and therefore can leave you with a damaged heart that will limit your activity and lifestyle.

No matter who you are, you should tell the EMT that you think you are having a heart attack, and they will go as fast as possible to the hospital and treat you on the way. If you cannot talk then make sure you partner with your partner and make sure you help each other communicate with the EMT and doctors.

Remember you only need to tell them that you think it is a heart attack and that your symptoms are, (choose yours), chest pain or chest pressure, shortness of breath, left arm pain, jaw pain, and or upper back pain.