Cardiac Problems and Conditions That Especially Affect Women

It's Not Just 'Anxiety'

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Heart disease is at least as important in women as it is in men. But in addition to the more classic forms of heart disease, there are certain "other" cardiovascular conditions that are seen predominantly in women, and which, unfortunately, are often mishandled by physicians.

”Typical” Heart Disease In Women

The most prominent cardiac conditions affecting women, of course, are the same diseases prominently seen in men: coronary artery disease and heart failure.

In women, however, these “typical” cardiac diseases often behave quite differently, and these differences all too often lead to confusion (on the part of both women and their doctors), and to inappropriate treatment.

Less Typical Cardiovascular Conditions In Women

Several less typical cardiovascular conditions predominantly affect women, and often produce problems in two distinct ways. First, the conditions themselves can cause significant symptoms. Second, doctors all too often write these symptoms off as being caused by "anxiety," when in fact they are caused by real medical problems.

So not only do the women with one of these less usual conditions suffer from the condition itself, they may also suffer from being inappropriately labeled as having a psychiatric problem.

If you have any of the following conditions, the first step in getting the help you really need is to learn as much as you can about the condition.

If nothing else, this will help you to determine whether your doctor is approaching your problem with the respect, and the expertise, it deserves.


Dysautonomias are a family of disorders that can produce symptoms involving almost any organ system in the body. Cardiac symptoms include chest pain, palpitations, dizziness and syncope (fainting).

It is very common for women (and men) who suffer from one of the dysautonomias to be labeled as being "anxious" (or otherwise crazy) by one or two doctors before finding a physician who makes the correct diagnosis.

The two most common forms of dysautonomia that strongly produce cardiovascular symptoms are inappropriate sinus tachycardia (IST) and postural orthostatic tachycardia syndrome (POTS). Both of these conditions can be highly disruptive to normal life, and because (like all dysautonomias) they tend to provide little in the way of objective abnormalities that can be measured and recorded by doctors, they are often written off as “anxiety.”


Palpitations, or an unusual awareness of the heartbeat, is often manifested by the feeling that your heart is racing, or skipping beats. The key to treating palpitations is making the correct diagnosis - that is, "capturing" one of the episodes of palpitations on an electrocardiogram (ECG). While it is not rocket science to accomplish this feat, far too many doctors drop the ball.

So if you have palpitations, you should know what your doctor really ought to be doing to get to the bottom of your problem.

Mitral Valve Prolapse

Unlike the cardiovascular conditions listed above, mitral valve prolapse (MVP) is diagnosed far too often, and is blamed for many things it does not cause. While in some women (who are readily identifiable by echocardiogram) MVP can cause significant mitral regurgitation, most of the time MVP is a trivial cardiac finding that is blamed inappropriately for a host of symptoms that are almost certainly due to dysautonomia.


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Furlan R, Barbic F, Casella F, et al.Neural autonomic control in orthostatic intolerance.Respir Physiol Neurobiol. 2009 Oct;169 Suppl 1:S17-20.

Zimetbaum, P, Josephson, ME. Evaluation of patients with palpitations. N Engl J Med 1998; 338:1369.

Kim, S, Kuroda, T, Nishinaga, M, et al. Relation between severity of mitral regurgitation and prognosis of mitral valve prolapse: Echocardiographic follow-up study. Am Heart J 1996; 132:348.

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