Imagine going in for a routine pre-operative EKG in which the medical professional is simply making sure all is well before surgery. The machine indicates you’ve had a massive heart attack on the front part of your heart.
You never felt anything. You never suffered symptoms. Your surgery is canceled. You’re sent to see a cardiologist. That person determines you’ve never had a heart attack.
Or how about this scenario:
You’re applying for life insurance. As part of your health screening, someone hooks you up to an EKG machine to make sure your ticker is working. You’re devastated when results show you’ve had a massive heart attack.
A reading like this could cause your proposed premium to skyrocket, if you were approved at all. That information would be logged in an insurance information bank and would remain on your record permanently.
Dr. Tracy Stevens, a cardiologist at St. Luke’s Regional Medical Center, said these things are happening to women.
“Just the basic EKG, the way it interprets the reading on women, is falsely reporting that they’ve had a heart attack,” said Stevens.
The problem, according to Stevens, is that the machines aren’t really meant for women.
“What’s important to know is that the computer in an EKG machine interprets based on research in white middle-aged males,” said Stevens.
An EKG machine typically has seven electrodes that are placed on specific locations on the body. Leads then run from those electrodes to the machine.
Stevens said the lead causing the issue for the women she’s seen is electrode V2.
This scan from a GE handbook for an EKG machine shows where each electrode is placed on the body.
Stevens showed us a normal EKG reading for the V2 lead.
And an abnormal one indicating a massive heart attack on the front part of the heart.
What’s the difference? On the normal reading, there is a spike up before a spike down. In the abnormal reading, there is no spike up.
Steven Weisbart with the Insurance Information Institute said an incorrect reading like what we’re describing could cause you to pay more for life insurance or cause a company to deny you coverage.
He also said that the information, once recorded by the originating company, is documented with what used to be called the Medical Information Bureau. Now, it is simply called MIB.
“A second company would be aware of it and would likely take the same action unless there was a way to convince the company, of course, the test was wrong,” he said.
Weisbart added that the insurance industry is unlikely to change any of its screening processes involving EKG machines unless research is done and a reputable medical journal determines it to be an issue. Then some companies might be willing to make changes to the way they read EKG results.
“What all of them would want as a minimum is some fairly rigorous academic experience that would suggest the machine might not be correct when dealing with a particular kind of issue or a particular population,” said Weisbart. “And as long as that’s in a refereed medical journal and has the endorsement of the editors of the journal, that might be enough. But for others it would take more than that.”
Stevens said if, after receiving an abnormal EKG, specifically lacking that up spike before the down spike on V2, the health care provider tells you it appears you’ve had a massive heart attack, you should ask the health care provider if that is based solely on the machine’s results or the provider’s interpretation.
To find out if you have an MIB file and see what’s on it, click here.
Also, Stevens recommended that women take part in medical research or medical surveys. Without research, no changes are made, and equipment and treatments don’t improve for women.
Her hope is with more research, medical professionals can start to understand women's bodies better and therefore develop more specific treatments for women.
Stevens recommends womenheart.org as one place to follow clinical trials.
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Christa Dubill can be reached at christa.dubill@kshb.com.
