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Stress May Skew Diagnoses For Women

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Bloomberg News

The Tampa Tribune

Published: October 13, 2008

Physicians and internists, when confronted with patients who are stressed out and show signs of heart problems, are more likely to chalk up the symptoms to anxiety if the sufferer is a woman, a study found.

When the patients didn't complain of a specific and recent source of stress in their lives, there was no difference in the way men and women were diagnosed for heart disease or referred to a cardiologist. The findings, presented at the Transcatheter Cardiovascular Therapeutics meeting in Washington on Sunday, may help explain why women often don't get prompt treatment for heart disease, which is their leading cause of death, the researchers said.

Doctors in the study read vignettes about a 47-year-old man or a 56-year-old woman, whose ages would have given them a similar risk of heart disease. When the story said the patient appeared anxious and reported a recent cause of stress, doctors interpreted chest pain, shortness of breath and irregular heart rates as psychological symptoms rather than heart disease more than twice as often in the woman. In reality, stress is a risk factor that can signal an elevated risk of heart disease in anyone, the researchers said.

"Given the overlap of coronary heart disease and anxiety symptoms ... doctors need to be especially careful to rule out coronary heart disease before considering an anxiety diagnosis," said Gabrielle Chiaramonte, a postdoctoral associate at Weill Medical College of Cornell University.

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