"THE HEART OF THE MATTER"
a special program of the National Emergency Medicine Association (NEMA)


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Week: 585.6 

Guests: Congresswoman Maxine Waters, D. CA, Dr. Patricia Davidson, Terri Maloney, Dr. Judy Hsia, George Washington University Hospital 

Topic: Women’s heart research 

Reporter: Aaron Cohen 

Host/Producer: Steve Girard 

NEMA: Thanks for joining us. A couple of stories for you today....we’ll talk about ways to avoid being bitten by an animal, and what you should do if it happens. But first, Health on the Hill. The leading cause of death among women is also the least understood. Cardiovascular disease takes the lives of over a half million women every year... 5 and a half times the number who die from other causes. Doctors, legislators and women themselves complain that little research is done into the unique causes of heart disease among women. Legislation is now being debated on Capitol Hill to find out why women’s hearts give out when they do. Aaron Cohen reports...  

COHEN: When men have heart attacks, suffer strokes or bouts of angina, doctors usually know how to treat them. But when women get heart-sick, treatment options are far less clear...ask Terri Maloney. 11 weeks after the joy of her baby Emily’s birth, the Virginia woman had to bury the infant...a victim of a rare congenital heart condition. Terri and her husband were subsequently tested and she was found to have a potentially life threatening heart condition of her own....  

MALONEY: You can imagine my devastation when, at learning at 34 that I had heart disease of unknown origin....had just lost my first child, and there was the possibility that my condition impacted the health of my children.  

COHEN: Terri’s predicament is not unheard of for a 34 year old...and it’s not all that rare that heart disease would go undetected in a woman. That’s what prompted California Democratic Congresswoman Maxine Waters to take action. Waters introduced a bill that would add 140 million dollars to the research budget of the National Heart, Lung & Blood Institute. If approved by Congress, the money would more than double what’s now being spent investigating cardiovascular disease in women...  

WATERS: It would educate women about the dire threat that heart disease poses to them...educate doctors on the risk and symptoms unique to women..and improve research and services for women with cardiovascular disease.  

COHEN: The universe of knowledge about the number one killer of women is alarmingly small, due in part to the relatively few number of women included in clinical trials, in studies, even those pertaining to the female hormone estrogen. That sort of ignorance is pointed out by Dr. Patricia Davidson, a cardiologist who says heart disease in women goes under diagnosed and under treated....  

DAVIDSON: We now know that many women present without the classic symptoms of angina described in medical textbooks, that were based on a male model. Fatigue and shortness of breath may be the only symptom. I recently diagnosed several severe triple vessel coronary artery disease in two women, who were both overweight and sedentary. There only symptom was their inability to complete shopping trips in their favorite department stores. That history I had to receive from their families, I did not hear it from the patients themselves. Now, I want to know...what is the DRG billing code for being unable to complete a shopping trip a Bloomingdales?  

COHEN: Dr. Davidson is in private practice and chairs an American Medical Womens’ Association panel on the health of minorities. And Davidson says like men, women are exposed to a number of risks for heart disease...  

DAVIDSON: So, each risk factor carries with it a different pathology, and it’s usually because the women have more than one risk factor and they tend to be diagnosed a little bit later...than we end up doing worse when we have our heart attacks.  

COHEN: Age may be the most important factor in why rates of heart disease for women have increased...women’s hearts lose the protective properties of estrogen after menopause, leading scientists to believe women become more vulnerable to heart disease after ‘the change’. The Heart, Lung & Blood Institute is focusing on replacing that hormone to maintain the heart’s defenses against the disease, but more lab work need to be done...says Dr. Judy Hsia. Dr. Hsia runs the Womens’ Health Initiative at The George Washington University Hospital in Washington...  

HSIA: I think the one area that could be suitably studies more would be the mechanisms by which estrogen could be protecting women, if it is, in fact protecting them...because it could also be that it’s protecting men, just that dosing was wrong in the coronary drug project, and that there may be a drug with broader utility than is currently practiced.  

COHEN: If Congresswoman Waters’ bill is approved, the California Democrat would like researchers to focus some of their attention on black women...that population has a higher death rate from stroke and heart disease than white women...and there’s what Dr. Davidson calls an "out of control" rate of diabetes among African American women...a disease that can trigger heart failure among its victims. With another 140 million dollars for research, the lawmaker hopes doctors can find a way to mend a truly broken heart. For Health on the Hill, I’m Aaron Cohen.  

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