Bhavnoor Pannu

Canada

A Dual Scoping Review of Factors Causing Misdiagnosis of Cardiovascular Diseases in Women

Bhavnoor Kaur Pannu, Trinity College, Unniversity of Toronto, Toronto, Canada

Abstract

The critical issue of misdiagnosis of cardiovascular diseases in women, highlights systemic disparities and the urgent need for scholarly and political action. Cardiovascular diseases are a leading cause of death for women globally, yet they remain understudied and often misdiagnosed, exacerbating women’s negative health outcomes. Misdiagnosis is a preventable medical error which disproportionately affects women, leading to delayed treatment, worsened disease profiles, and increased mortality. Despite ongoing legal battles and global efforts for equitable healthcare, challenges in quantifying misdiagnosis persist, underscoring the importance of proactive measures to prevent misdiagnosis and create equitable healthcare for all patients. This review addresses these challenges by mapping evidence related to misdiagnosis, informing future research, intervention strategies, and healthcare advocacy efforts, ultimately improving outcomes for women with cardiovascular
diseases.

This is a dual-scoping review which systematically maps primary and secondary literature on cardiovascular disease misdiagnosis in women, aiming to determine the scope of cardiovascular misdiagnosis literature while identifying gaps in current approaches. Part I focuses on secondary literature, to compile a comprehensive list of risk factors and variables associated with misdiagnosis. Part II examines primary literature, employing a refined search strategy across PubMed and Scopus. Articles meeting inclusion criteria are analysed against the list of variables established in Part I to identify themes, and gaps, and propose implications for clinical practice, research, and policy.

Part I identified 29 variables and risk factors associated with the misdiagnosis of cardiovascular diseases in women, categorized into biological sex, gender identity, and race. Part II visualized primary research against these variables, revealing disparities in the consideration of these risk factors. While biological factors were addressed relatively regularly (30%), social gender variables were considered sparingly (7.02%). Case reports dominated the type of primary literature, while most types of primary sources performed relatively equally at evaluating misdiagnosis risk factors (~22% coverage).

This dual-scoping review underscores the urgent need for comprehensive research into the misdiagnosis of cardiovascular diseases in women. These findings highlight the need for greater emphasis on social determinants of health in primary research and underscore the importance of addressing disparities in research representation and study design to enhance understanding and mitigation of cardiovascular disease misdiagnosis in women.