Cardiac screening studies find heart conditions in young women at rates comparable to men

Why it matters locally: Dr. Jonathan Chen, director of preventive cardiology at the University of Michigan, is among medical professionals calling for equal screening protocols for young women, noting that current diagnostic tools require no invasive procedures or radiation exposure.

Cardiologists are reassessing screening practices for sudden cardiac death after studies detected heart abnormalities in young women at rates comparable to young men, challenging assumptions that have traditionally guided medical evaluation. Sudden cardiac death claims approximately 300,000 lives annually in the United States, according to the American Heart Association. Medical professionals have historically concentrated screening efforts on young male athletes, focusing particular attention on conditions like hypertrophic cardiomyopathy and arrhythmogenic right ventricular cardiomyopathy. Recent screening initiatives that examined young women without symptoms of heart disease identified structural and electrical cardiac abnormalities at frequencies researchers say warrant clinical attention. The studies employed electrocardiograms, echocardiograms, and genetic testing to detect conditions that can trigger life-threatening heart rhythms without warning. "We're finding that women carry these conditions at comparable rates to men," said Dr. Sarah Martinez, a cardiologist at Boston Children's Hospital who participated in one screening effort. "The difference is women haven't been screened with the same intensity." Medical textbooks and clinical guidelines have typically emphasized sudden cardiac death as a risk primarily affecting young competitive athletes and active men. Women presenting with similar underlying conditions often received different clinical pathways or delayed diagnosis, researchers said. The screening data raises questions about why women have not received equivalent diagnostic attention. Some medical professionals attribute the disparity to historical focus on male athletes in sports cardiology. Others cite differences in how symptoms present between genders, noting that women may experience atypical warning signs that don't align with existing diagnostic criteria developed largely from male patient populations. Cardiac conditions that cause sudden death frequently produce no symptoms during everyday activities. Individuals can function normally for years before experiencing a catastrophic event triggered by exercise, extreme emotional stress, or in some cases during sleep. Dr. Jonathan Chen, director of preventive cardiology at the University of Michigan, noted that screening young women for these conditions requires neither invasive procedures nor radiation exposure. "We have the tools. The question is whether we deploy them equally," Chen said. The findings have prompted several professional cardiology organizations to examine their screening recommendations. The American College of Cardiology convened a working group last year to evaluate gender differences in sudden cardiac death risk and diagnostic approaches. Screening asymptomatic populations remains medically complex. Some conditions identified through screening never cause clinical symptoms during a person's lifetime, raising questions about the benefits and psychological impact of diagnosis. Medical professionals emphasize that screening decisions should follow established clinical guidelines and occur with informed consent. The studies involved between 500 and 2,000 young women each, drawn from college athlete populations and community samples. Researchers plan additional investigations to determine optimal screening protocols and whether early detection and intervention reduce mortality rates in women.