Women’s chances of surviving a heart attack are higher if they’re treated by a woman rather than a man in the emergency room, according to a new study.
The study, published Monday in the journal Proceedings of the National Academy of Sciences, found that gender matters when it comes to heart attack survival but only when it comes to a male doctor treating a female patient.
Women treated by men were about 1.5 per cent less likely to survive than men treated by women. This might not sound like a big difference but all things are relative, said study co-author Brad Greenwood of the Carlson School of Management at the University of Minnesota-Twin Cities.
The study examined more than 500,000 heart attack patients admitted to Florida hospitals between 1991 and 2010. Given how many of those patients were women treated by male doctors, he estimates that the gender effect might account for the deaths of around 1,500 women.
Women in general have worse survival rates for heart attacks than men, said Greenwood.
This is partly because women often delay seeking treatment for their symptoms and also experience heart attacks differently than men. “They often present asymptomatically,” he said. “Whereas men will present with chest pain, elephant on the chest, women are more likely to present with displaced pain or flu-like symptoms and may be more challenging to diagnose and treat.”
WATCH: How do women’s heart attack symptoms differ from men’s?
Early heart attack symptoms are missed in 78 per cent of women, according to a recent report by Heart and Stroke.
Dr. Paula Harvey, chief of medicine and director of cardiovascular research at Women’s College Hospital in Toronto, said that the male symptoms — that “elephant on your chest” feeling — was the model of a heart attack taught in medical school until the last couple of decades.
But that doesn’t really account for why female physicians seem to treat women more successfully than male physicians do. There’s some evidence that shows patients with many conditions have better outcomes when treated by a female doctor, she said. Still, heart attacks might be a special case.
“It may be that it’s an education and knowledge issue where the men don’t recognize that women present with a somewhat different pattern of symptoms than what men do when having a heart attack,” said Dr. Harvey.
It could also be that women are more comfortable discussing their problems with another woman, said Greenwood, or that female doctors are better at picking up on cues that a woman might have a cardiovascular problem.
WATCH: A Heart & Stroke report shows Canadian women are “unnecessarily suffering and dying of heart disease.” As Allison Vuchnich reports, women are under-researched, under-diagnosed, and under-aware.
Women are also less likely to receive aggressive diagnostic procedures and treatment for their heart attack symptoms, according to Heart and Stroke.
The study also found that male physicians tended to improve the survival rate of their female patients the more often they treated women. Male doctors also did better when there were more female doctors in the emergency room.
“It isn’t as if males are existing in a vacuum. They are learning,” said Greenwood.
Harvey believes that more research is needed to figure out why women treat female heart attack patients more successfully, as although things have improved, she still sees cases where women’s heart attack symptoms are missed.
“It’s something that I have seen across my career and I still see it, unfortunately, where a woman’s presentation would be attributed to an alternative cause,” said Dr. Harvey.
“So their discomfort that they’re experiencing in their chest or in their throat may be attributed to something like indigestion rather than to a heart problem. Or their feeling of fatigue or sweating or discomfort may be attributed to anxiety. Unfortunately, I’ve seen that a number of times.”
Greenwood believes that increasing diversity in the emergency room would be a good place to start improving patient outcomes. “I don’t think that the implication is that only women should treat women and only men should treat men,” he said.