At her next visit to her family physician the following week, Karen described the symptoms she experienced on the evening of her emergency department visit. She said the symptoms went away by the next morning. Her family doctor, who had recently been reading about sex differences in cardiovascular disease, thought it might not have been a flu after all, and arranged for Karen to have a stress test and echocardiogram. The results of these tests indicated a poorly functioning region in Karen’s right ventricular wall and ECG changes that indicated a recent myocardial infarction.
Karen was alarmed by this news, as she had always considered heart disease a "man’s disease" and hadn’t experienced the crushing chest pain she associated with a heart attack. Karen had never discussed heart disease or been screened for it, though her husband had been evaluated regularly.