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    Heart Biases That Can Kill

    Millions of Americans experience heart attack symptoms each year. So why do some get better treatment than others?

    Wealth Allows Heart-Healthy Lifestyle

    Doctors may also believe that poorer people are less likely -- or even able -- to follow a lifestyle that can prevent heart attacks.

    "If you go 10 blocks south of my hospital, you're in one of the wealthiest neighborhoods in the U.S., but if you go 10 blocks north, you're in one of the poorest," says cardiologist Ira Nash, MD, of Mount Sinai School of Medicine in New York City and a spokesman for the American Heart Association.

    "The difference of food available is those two neighborhoods is striking. You cannot find fresh foods or even fresh milk in the poor neighborhood, which is populated primarily by minorities. All there is available is fast food and prepackaged, highly processed carbs," he says. "When people talk about the role of stress in heart disease, many think of the high-pressured executive. I think it's a lot more stressful to be a welfare mother."

    That may explain what Curry has seen in his own hospital.

    "I've never known a doctor who met a poor man and would say, 'I'm not going to do all I can do to save his life,'" he says. "But in my hospital, we treat everyone from congressmen to homeless people, and I have seen that some doctors do not spend as much time with that homeless man as they would with a congressman."

    What You Can Do

    So how can you get better care for a potential heart attack, no matter your race, income level, or sex?

    • Get wise to all the symptoms. In addition to chest pain or difficulty breathing, heart attack symptoms can also include an unexplained feeling of fullness; indigestion, gas, or nausea; lightheadedness; sweating; or pain in the arms, jaw, neck, or back. "Doctors have to be aware that if discomfort occurs from the navel to the nose, they should think of a heart attack first," says Curry.
    • Call 911. That ensures you'll get an ambulance to take you to the hospital and therefore be cared for more quickly. Guidelines for hospital accreditation require that ambulance-arriving patients suspected of having heart attacks must get an EKG within 10 minutes after arrival and a doctor's exam within 30; those arriving on their own don't fall under these guidelines, says Curry.
    • Bring an advocate. A friend or family member can better serve as the doctor's eyes and ears. "The patient may talk about some pain, but a spouse will be more likely to describe other symptoms. Your spouse is probably more likely to tell the doctor of sweating or other symptoms."

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