‘I was dying’: Heart patient understands disparities between men and women with heart disease

Care is usually unilateral even though men and women have different symptoms, bodies

SAN ANTONIO – The disparity in healthcare between men and women isn’t just a belief - it’s a fact.

Heart disease is the leading cause of death for women, but a new study showed 65% of women who have high-risk factors are not even referred to specialists.

It also showed that over three-quarters of women 50 or older are managing conditions that could cause aortic stenosis, yet a mere 25% have been referred to a cardiologist.

The top doctors in the field admit that big changes need to happen quickly before more women are overlooked.

Katherine Guijarro’s birthday is in January, but in her mind, that’s not her only one.

“April 24, 2023 is my new birthday, and I sincerely believe that, because that was when I got a new lease on life,” Guijarro said.

That new lease on life, produced by a long overdue heart surgery.

In 2016, doctors found a heart murmur, and by 2022 she was told she needed surgery.

Six years had passed, and by then, things were bad.

“Major fatigue, shortness of breath, which got worse and worse over time. I couldn’t walk from my bedroom to the front door. I was already making plans to go into an assisted living. And, you know, that I was dying,” Guijarro said.

It wasn’t until 2023 she saw the cardiologists who did a high-tech, minimally invasive procedure that lifted her symptoms immediately.

“We have to do a better job as physicians listening and allowing our patients to talk to us so that we can tease out some of these really important factors which will lead us to the right diagnosis,” said Guijarro’s surgeon, Dr. Jorge Alvarez.

Dr. Alvarez is the Director of Methodist Healthcare’s Structural Heart Program.

Alvarez sees between 30 and 40 patients a day, constantly keeping in mind the differences between women and men.

Some of those differences are anatomical. The arteries carry blood from the heart to the body. Women, in general, have smaller arteries than men, which can lead to different symptoms.

“Men will have your typical you know, ‘I get lightheaded dizzy. I have chest pain,’” Alvarez said.

Women rarely have that crushing chest pain or the pain shooting down the arm. Instead, they feel the way Guijarro did.

“Fatigue and shortness of breath are probably the two most common symptoms. We need to be able to adjust for that and treat it sooner,” Alvarez said.

Alvarez emphasized that doctors cannot use a one-size-fits-all approach.

When it comes to the acknowledgment of the necessary changes, Alvarez said, “In the past ten years, I think we’ve made some gains. You can see not only in clinical studies, that women are being represented a little bit better.”

He mentioned a major study that was just presented at the American College of Cardiology.

“I want to say it was about 80% of the people enrolled were actually women. It was looking at smaller valves and comparing two different valve types and showing that was one better than the other. And the fact that it really was mostly women that were in the study was huge, because we don’t tend to do a good job of that,” Alvarez said.

While the dial is moving, Guijarro wants even better results.

She wants women to make it to the doctor, and advocate for themselves.

“I can’t believe I lived like that. I’m like a new person,” she said.

She’s that new person, with new places to go, a new business to start, and a newfound, life-changing sense of freedom.

Alvarez agreed with his patient, telling women, “If you don’t feel well, there’s always a reason. If you don’t like the answer you get, or you feel like you’re not being paid attention to enough, then find someone else. I mean, you have to be your own advocate.”

Alvarez said that especially goes for Hispanic women, who make up so much of our community.

“I think here in San Antonio, I think there’s sometimes the language barrier is big, but there’s ways to overcome that. We have to do a better job as the physicians being able to understand those cultural differences, and understanding where they come from so that we can explain things to them,” Alvarez said.

He also knows access is close to impossible when it comes to finding a doctor, even a primary care provider.

“What’s really frustrating for certain people is they’ll call the primary care, ‘Oh, we’re not taking new patients.’ Or another one, ‘Oh, we don’t take Medicare.’ When they call another one, ‘Well yeah, we can see you in 2026.’ That’s really tough for people so they just give up. And that’s why we need to be we need to do a better job,” Alvarez said.

The suggestion for people having trouble getting through to a doctor is to call the main hospital systems to see if they can find a provider in one of their clinics that fills their needs

When it comes to heart health, it’s a race against time.

“The earlier you recognize and sense your symptoms, and the sooner you go and try to get somebody to help you out with those, the better off you’ll be. Because there is a point where the horse is kind of out of the barn and there’s not a whole lot we can do now. We’ll try, but I can’t promise you the same results you would have had six months ago,” Alvarez said.

When women find a doctor, both Guijarro and Alvarez encourage them to make the appointment.

“If you’re a mother, grandmother, wife, you’re just not allowed to get sick, because when you get sick, the house tends to not work as well. So they put a lot of pressure on themselves not to be sick, and they ignore symptoms,” Alvarez said. “I always tell people you wouldn’t let your own kids get away without looking into this or getting checked out. So why do you let yourself go without getting evaluated?”

Taking care of yourself can set an example for the rest of the family that self-care and healthcare should be a priority.

About the Authors

Courtney Friedman anchors KSAT’s weekend evening shows and reports during the week. Her ongoing Loving in Fear series confronts Bexar County’s domestic violence epidemic. She joined KSAT in 2014 and is proud to call the SA and South Texas community home. She came to San Antonio from KYTX CBS 19 in Tyler, where she also anchored & reported.

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