What are the problems in diagnosis of heart disease in women?
In general, heart disease is less common in women of childbearing age group. Hence both the patient and physician has low index of suspicion when women do have heart disease. Moreover symptoms may be atypical in some women. These may lead to delay in diagnosis.
Which types of heart disease are likely to occur more in women?
Though diseases of blood vessels of the heart (coronary artery disease) is less common in women of childbearing age, rheumatic heart disease secondary to rheumatic fever is often more common in women in regions where it is prevalent. Hence valvular heart disease due to rheumatic fever may cause problems during pregnancy. In postmenopausal women coronary artery disease is probably as common as in men, especially in the elderly. Response to treatment is also sometimes suboptimal in women when they do have heart disease and it is the top cause of mortality in elderly women.
A specific form of heart disease in women is peripartum cardiomyopathy which occurs in late stages of pregnancy or soon after delivery. In this disease, heart muscle becomes quite weak and they become breathless and may go into heart failure. Usually this disease recovers spontaneously after delivery, though there is high chance of recurrence in subsequent pregnancies, especially if the heart function has not fully recovered after delivery. Clots in veins are also sometimes more often seen in women than in men. Certain birth defects of the heart like atrial septal defect (defect in the wall between the upper chambers of the heart) are also more common in women.