Women are more likely to experience serious complications after heart surgery than men are, a new study finds.
Researchers say female patients are nearly 40 percent more likely to have a bad outcome and about twice as likely to have a stroke or die after a procedure as male patients.
They believe women may not be diagnosed with heart problems as quickly as men are or that women’s hearts and blood vessels are more ‘fragile’ and, therefore, they need more delicate procedures than the ones men undergo.
The team, led by Lawson Health Research Institute in Ontario, Canada, says it hopes the findings leading to cardiologists practicing more personalized medicine as opposed to a standard approach for all their patients.
A new study has found that women are 40 percent more likely to have a bad outcome following heart surgery than men are (file image)
For the study, published in Circulation, the team looked at 1,700 male and female patients who had surgery across 10 clinics in Canada for a thoracic aortic aneurysm.
The aorta is the body’s main artery that carries blood from the heart to the rest of the body.
A thoracic aortic aneurysm occurs when a weakened area of the upper part of the aorta creates a bulge.
This bulge can rupture and lead to a tear in the artery wall, which causes life-threatening bleeding, according to the Mayo Clinic.
Researchers studied three different surgery outcomes: complications, stroke and early death.
In every category, women fared worse than men.
The team found that women were 40 percent more likely to have a complication, 90 percent more likely to have a stroke and 80 percent more likely to die.
‘We controlled for patients’ age, weight, pre-operative health, co-morbidities,’ said lead author Dr Jennifer Chung, a cardiac surgeon at Peter Munk Cardiac Centre in Toronto, Ontario.
‘When we took all of that into consideration, going into aortic arch surgery, you’re slightly less than twice as likely to die if you’re a woman.’
The authors say they’re not sure why these differences in sex occur, but they have a few theories.
One theory is that women don’t tend to show symptoms until a complication, such as a ruptured aorta, occurs.
In that case, the risk of emergency surgery is 10 times higher than a non-emergency procedure, known as an elective surgery, according to the Lawson Institute.
Additionally, when women do show symptoms, they might not be typical ones like dizziness and chest pain.
‘Similar to other areas in cardiovascular medicine, our study suggests women present later in the disease process perhaps with atypical symptoms, like nausea,’ said senior investigator Dr Michael Chu, a clinician scientist at Lawson Health Research Institute and cardiac surgeon at London Health Sciences Centre.
‘This may explain the difference in outcome between women and men in emergency situations, when patients experience something like an aortic dissection, or a ruptured aorta.
“But even still – we analyzed both situations – when people came for elective versus emergency surgery – and women still did worse either way.’
He also said an aortic aneurysm may be more severe in a woman than in a man.
Dr Chu told The London Free Press that, for example, a doctor many not recognize that an aorta measuring 55 millimeters is less severe for a man than it is for a woman.
The team says more research is needed to understand why this gender bias exists in cardiovascular medicine – and other fields.
‘We have discovered an unfortunate phenomenon that will hopefully lead us down a path of more personalized medicine,’ said Dr Chung.
‘This helps us understand that surgery shouldn’t be the same for men and women, and that we must educate ourselves about picking up symptoms in women sooner.
‘Our take home is that we need to do more research.’