For years, heart disease in women was misdiagnosed as stress or anxiety. A growing body of research demonstrates that heart disease presents differently in women than in men. Yet physicians may still lack awareness of these differences or the expertise to diagnose and treat them.

Through Cedars-Sinai’s Virtual Second Opinion platform, women across the country can now receive second opinion reports from women’s heart specialists renowned for their skill and experience in providing sex-specific care. The service gives women an opportunity to request a virtual second opinion from distinguished faculty from the Barbra Streisand Women’s Heart Center in the Smidt Heart Institute at Cedars-Sinai. Women seeking a second opinion about an established diagnosis can find help using the new service.

Here, C. Noel Bairey Merz, MD, director of the Barbra Streisand Women’s Heart Center and the Irwin and Sheila Allen Chair in Women’s Heart Research; Martha Gulati, MD, associate director of the Barbra Streisand Women’s Heart Center, director of Preventive Cardiology, and the Anita Dann Friedman Chair in Women's Cardiovascular Medicine and Research; Janet Wei, MD, co-director of the Stress Echocardiography Lab; and Ana Iribarren, MD, a cardiologist working at the Barbra Streisand Women’s Heart Center, share how Cedars-Sinai’s Virtual Second Opinion can help make a difference in women’s lives.

Martha Gulati, MD: Females with heart conditions are more likely than men to be misdiagnosed or undertreated. Women can often feel like they’re jumping through hoops just to be heard. Our clinic is run by expert women cardiologists who are passionate about improving equity in cardiovascular care. By utilizing this new platform, women looking for a second opinion will have an opportunity to access the right resources—even if they don’t live here in Los Angeles.

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Janet Wei, MD: Women should consider seeking a virtual second opinion when there are clinical questions their providers cannot answer or if they have symptoms that aren’t getting better with the treatments offered to them. Often, second opinion participants are referred to us by their physicians who are not experts in women’s cardiovascular issues. We see ourselves as collaborators with their treating physicians: Our sole goal is for women to feel empowered about their care, no matter who is providing it.

MG: Our center specializes in ischemia with no obstructive coronary arteries—we’re at the forefront of that area of research, including multiple ongoing clinical trials. We also focus on prevention of cardiovascular disease. So, we welcome all women in need of a second opinion about heart disease or previously diagnosed heart symptoms that have not been adequately addressed. We are also happy to review records and opine on whether women are on appropriate preventive therapies.

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Ana Iribarren, MD: Dr. Bairey Merz and I recently provided a virtual second opinion for an individual who was herself a physician. She had been experiencing chest pain, and her doctor had ordered standard tests, but the results did not show anything abnormal, and her symptoms were labeled as “noncardiac.” Upon review of her medical records, we immediately realized there was additional imaging that had not been done, and treatments that were not recommended. The fact that even a doctor was in this position highlights the challenge many women can face finding appropriate heart-related care.

JW: Upon registering through the online platform, one of our nurse coordinators will contact you to help pair you with the appropriate specialist and assist in the medical record collection process. All of your relevant medical records (including past test results and cardiac imaging) will be shared with the specialist so they have a comprehensive understanding of what has been done so far. Our physicians and nurse practitioners will work together to review the medical records, providing a written report that answers the questions submitted during enrollment. This written report is followed with an option to participate in a virtual education session, where the specialist will review the second opinion report and answer questions about it. Each participant will benefit from having the opportunity to receive a second opinion from a physician on the Women’s Heart team.

C. Noel Bairey Merz, MD: Let’s say you have a cardiac problem where the diagnosis doesn’t feel right, or you’re considering whether to go forward with a doctor’s recommendation for potentially dangerous procedures like invasive testing or open-heart surgery. These can be big and consequential decisions, and you want to look before you leap. As a center of excellence in the arena of women’s cardiac health with more than 30 years of experience in evidence-based medicine, the Barbra Streisand Women’s Heart Center is well equipped to help you ensure that any risk is offset by reward.

To learn more, visit cedars-sinai.org/secondopinion.

Read: Women’s Health and Sex Differences: Research Update