Heart revolution changing women’s lives

A leading cardiologist says a lack of female practitioners has led to women being misdiagnosed and overlooked in coronary heart disease.

After being diagnosed with a series of microvascular disorders, a sense of relief washed over Jody Rochecouste, who until three months ago had been searching for what was wrong with her health for 30 years.

Once chalked up to anxiety and imagination by doctors who couldn’t provide answers for her breathlessness and fatigue, the 56-year-old now knows she has a combination of microvascular disorders including angina, hypertension and microvascular disease.

A hidden affliction, microvascular disorders are a type of coronary heart disease that is seen in small blood vessels and disproportionately affects women.

The disorders are considered harder to detect, as evidenced by Ms Rochecouste whose angiograms, electrocardiograms and other tests pointed to nothing.

“I was laughed at by one doctor and I cannot tell you how that made me feel,” she said.

Jody Rochecouste with her husband Mario. Picture: Supplied

“He was telling me that I had anxiety and what it was causing was all imagined in my head … I became hesitant every time I went to the doctors and I’d leave things too late and in the end I’d have to go to hospital,”

But in a bittersweet vindication, following a visit to the Alfred Women’s Heart Clinic in Melbourne, Ms Rochecouste at last has her diagnosis and the right medication to treat it.

Her disorders were detected through a special type of angiogram involving pressure wire technology, where wires four times the width of a strand of hair are inserted into a catheter and travel to the heart to record physiological measurements.

The test is considered a special skill and is not administered in a standard angiogram.

Ms Rochecouste said her new-found knowledge has made her caution her daughter who is experiencing similar symptoms.

“She’s in her early 30s and she’s gone to the hospital a number of times in the past couple of years, and they’re kind of ignoring her and I’m like: don’t let them do that because you don’t want to spend over 30 years like I did to get the diagnosis.”

Dr Monique Watts established the Alfred Women's Heart Clinic in 2018.

Dr Monique Watts, who established the Alfred Women’s Heart Clinic in 2018, said being a woman in a male-dominated field helped her detect and raise awareness on microvascular disorders, with just 13 per cent of cardiologists in Victoria female.

“What I found was by virtue of being a female doctor, I was seeing almost exclusively female patients (so) I saw more of the fe­male pathology and I was starting to see patterns,” Dr Watts said.

“We certainly need to encourage more women into cardiology, because although we’ve got fabulous male cardiologists, it’s no secret the champions of women’s heart disease are women’s heart health cardiologists.”

She said knowledge of heart disease comes from studies largely conducted with men and has led to “incorrect assumptions” that male and female hearts behave the same despite different physical and biological factors.

Dr Watts is working to develop a protocol for doctors to be trained in administering the test to detect microvascular disorders.