In the last article, I discussed the massive variation in our healthcare system. This piece reviews our high rates of inappropriate care as a major cause of poor health outcomes and very high cost. Women with heart artery disease may be the best example of this problem. Mismanagement in this group of patients is more the rule than the exception. There is a huge disconnect here between medical science and medical practice.
Men have localized blockages of their heart arteries. That consistently leads to symptoms like chest pain and shortness of breath with exertion. Women, on the other hand, are at increased risk of a heart attack or sudden death when they have little or no heart artery blockage. They have cholesterol deposits that rupture and cause clots that block the artery and damage heart muscle. They have chest pain, shortness of breath, and weakness that are not related to exercise. Our entire heart care system is designed to find blockages and open them. When women with stable chest pain have a stress test and a catheterization and no blockages, they are frequently told they don’t have heart disease. “It is your esophagus.”
The answer to their problem is optimal medical therapy to stabilize their cholesterol deposits and prevent clots and heart attacks. They get their stress test and catheterizations, but they don’t get optimal medical therapy. As a consequence, thousands of them have heart attacks or die annually. They continue to suffer, and they cost a lot of money. There is no clearer example of a high rate of inappropriate care that is harming patients and increasing cost.
The research has been done that mandates a change in the way we treat women with chest pain. Perverse financial incentive put our mothers, wives, and daughters at risk every day. We can improve their health and save money now. Our system routinely provides inappropriate care for women with chest pain. Let’s fix it.
Mark Houston: ““Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking”.
https://pubmed.ncbi.nlm.nih.gov/29316855/
The summary of the article: “We don’t know what to do”. This statement highlights the reason why we exist and must succeed!
Thankfully, we have built solutions to spearhead this transformation. Exciting times are straight ahead! This is the dawn of the darkness!