Heart disease is the leading cause of death in the U.S., yet experts agree the condition is often misdiagnosed in women.
For American Heart Month, doctors and patients are speaking out to help ensure that women’s symptoms get life-saving attention and treatment.
Dr. Philip Adamson, chief medical officer of Abbott’s Heart Failure Division, said women are often diagnosed with anxiety or depression when they are short of breath or experience fatigue — when the true culprit is heart failure.
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"Women can also be diagnosed with these conditions when they present with fast heart beats or ‘palpitations’ that can be the result of abnormal heart rhythms," Adamson, who is based in Austin, Texas, told Fox News Digital.
"Several objective studies found that there is a systematic bias that leads doctors to misdiagnose coronary heart disease and heart failure in women."
Studies have shown women are 52% more likely to have a delay in diagnosis than men when presenting with a heart attack, according to Dr. Bradley Serwer, a cardiologist and chief medical officer at VitalSolution, a Cincinnati, Ohio-based company that offers cardiovascular and anesthesiology services to hospitals.
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"Because heart disease may be under recognized in women, studies have shown that they receive less aggressive treatment," Serwer told Fox News Digital.
"Women also have a lower representation in clinical trials assessing therapies for heart attacks than men."
Here's what to know.
Carol Pollard, 79, who lives in San Jose, California, is all too familiar with the danger of misdiagnosis. A few years ago, when the grandmother started feeling out of breath and very fatigued, she — and her doctors — at first chalked it up to getting older.
"My husband and I went to five cardiologists — and all five misdiagnosed me," she told Fox News Digital in a phone interview.
Pollard was ultimately diagnosed with mitral valve regurgitation — otherwise known as a leaky valve — which is when the valve doesn't close tightly and blood flows backward into the heart.
She was placed on a variety of drugs, but none of them helped much with her breathing issues.
"At the time, the team of doctors couldn't decide whether I was a little crazy or whether I was having panic attacks," Pollard said.
"They planted that seed of doubt and I said to myself, ‘You have to listen to them,’" she went on. "So I went on the drugs they wanted me to go on, but I still couldn't breathe."
It was only later, when she was having additional tests to find alternate treatments for the leaky valve, that Pollard learned she had another condition that everyone had overlooked.
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"A heart biopsy finally gave us a diagnosis that all of them had missed, which is, I have a rare heart disease called cardiac amyloidosis," Pollard said.
With cardiac amyloidosis, a protein called amyloid builds up in the heart, which prevents it from functioning as it should.
"A rogue protein that developed in my bone marrow transferred into my blood and then attacked my heart, kidneys and GI tract," she said.
The only treatment for the condition was chemotherapy, which Pollard received for a year.
"They finally got me into remission, but I still couldn't breathe due to the leaky valve," she said.
Eventually, a doctor introduced Pollard to Abbott Laboratories, a medical products company that produces the MitraClip. It's small device that clips the valve together and prevents blood from flowing back into the heart.
After a long road of testing and pre-qualifications, Pollard underwent the mitral valve procedure.
"The day after [the surgeon] put that clip in my heart, I could breathe again for the first time normally in I don’t know how long," Pollard said. "I was so elated and amazed and happy that when my daughter arrived at the hospital, we actually danced in the hospital room."
Today, Pollard is feeling "pretty good," although her cardiac amyloidosis is back. She still gets chemo once a month for that condition and sees her regular cardiologist and hematologist every few months.
Pollard’s breathing is fine thanks to the MitraClip, which she calls a "miracle procedure that saved my life and my sanity."
Tina Marie Marston, 49, also had a long journey to her heart diagnosis.
When she was 28, the Georgia mother started experiencing symptoms of heart failure during pregnancy — fluid retention, shortness of breath, extreme nausea and vomiting.
"I was just so sick throughout that pregnancy and nothing seemed to be alarming [the doctors]," she told Fox News Digital in an interview. "It was just like, ‘Oh, you're pregnant. This is just what happens.’"
Even months after giving birth, Marston said she "just never felt right — I always felt like something was off."
In 2002, Marston returned to the hospital to get her symptoms checked.
"I remember the doctor listening to me with a stethoscope, but he didn’t run any type of X-rays or do any bloodwork," she said.
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The doctor told Marston she had "a touch of walking pneumonia," then gave her a prescription and said to allow three days for it to work.
"On the second day, I called a friend and I said I have to go back to the ER, because if I go to sleep, I’m not going to wake up," she said.
That was when the doctors discovered that Marston had a hole in her lung, congestive heart failure, full-blown pneumonia and postpartum cardiomyopathy — which is heart failure that occurs between the last month of pregnancy and five months after delivery.
"The doctor told me not to come back for three days, but I came back two days later," she said. "What would have happened if I hadn’t come back?"
After spending a few days in the ICU, Marston was discharged and adopted a whole new lifestyle, with a focus on heart-healthy nutrition.
A few years later, in 2010, she experienced another life-threatening misdiagnosis. When Marston went to the hospital with excruciating leg pain, she was told it was a pinched nerve — but days later, doctors realized her legs were riddled with dangerous blood clots that had to be surgically removed.
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"I could have lost both legs," she said. "I had no blood flow for at least a week."
In her late 30s, Marston received an LVAD (left ventricular assist device) — the HeartMate II by Abbott — a device that helps the heart pump blood from its lower chambers to the rest of the body.
To help other women facing the same struggles, Marston recently founded a nonprofit called the Tina Marie Marston Foundation. She is also a legislative advocate for the Georgia American Heart Association.
While it’s difficult to put a number on how many cases of women’s heart disease go misdiagnosed in the U.S., Adamson said it is "common."
"Objective studies have found there is a medical bias that women are at low risk for developing heart problems," he noted. "This bias exists for all cardiovascular diseases, from coronary issues to late-stage heart failure."
"The bias is particularly common in women who suffer from a unique type of heart failure that arises because the heart is stiff and cannot adequately relax, which the medical community calls ‘heart failure with preserved ejection fraction,’" Adamson said.
"Many women with this type of heart failure, especially women of African descent, downplay their symptoms or don’t seek care because they are busy caregivers who often also work outside the home," the doctor noted.
To prevent potentially deadly misdiagnoses, Adamson emphasized the importance of women being their own advocates.
"Women’s health is a very important issue and requires self-advocacy to find the right medical provider who recognizes the bias," he told Fox News Digital.
"Tina [Marston] is a great example of someone who knew something was wrong and advocated for appropriate treatment," he said. "She would not let the system blow her off — instead, she took things into her own hands and found what was available on her own."
The doctor said it’s essential to find the right provider who understands how to properly manage blood pressure, cholesterol, diabetes, weight control and other risk factors – including genetics – for developing early heart disease.
"I can’t emphasize enough how important it is for women to be aware of their health and partner with health care providers who have overcome the typical biases leading to misdiagnoses," Adamson added.
"Sometimes the problem is anxiety, but make sure all options have been considered. We need to care for the amazing heart."
Serwer, the Ohio cardiologist, also noted that not all women will experience classic symptoms like chest pain.
"Be aware that heart attack symptoms for women may include shortness of breath, abdominal pain, nausea or just not feeling right," he told Fox News Digital.
The doctor also urged women to be aware of their individual risks for developing heart disease and start making modifications early.
"Know your medical conditions and your family history," Serwer advised. "Sit down with your health care team to help identify ways to reduce your risk. Don’t wait until after you have a heart attack to start treating your high blood pressure, cholesterol and diabetes."
If symptoms do arise, the doctor said, don’t ignore them.
"Seek medical attention and raise the concern that you may be afraid you're having a heart attack."
To other women, Pollard’s advice is to "listen to your body — because I wasn't listening to mine."
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She told Fox News Digital, "I think many times, women are misdiagnosed because they don't pay attention to themselves. There's that ‘no pain, no gain’ mentality … I think we are given these messages that teach us to ignore the signals of our body," she said.
"Our body is very smart, and when it's telling you something is wrong, you need to listen to it."
"I take part of the blame for taking so long to be diagnosed because I wasn't taking my pain seriously," she added.
"Being out of breath and terribly fatigued is not necessarily a part of getting old."
Marston advised women to "never second-guess yourself" and to never hesitate to ask questions.
"It should be a partnership where you're working together with your doctors," she said.
"You should have a team that accepts questions without any hesitation."
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