Debbie Summers

[Afshine Emrani MD FACC @afshineemrani]

I'm a cardiologist. A 42-year-old mother of two came to my office complaining of jaw pain and crushing fatigue. She ran half-marathons. Her EKG was normal. Another doctor had sent her home with anxiety medication.
When I got her into the cath lab, I found severe microvascular disease — plaque choking the tiniest vessels of her heart, the ones standard angiograms routinely miss.
Her heart had been starving in silence while everyone told her she was stressed.
She is alive today. Too many women like her are not.
Heart disease kills more women than every cancer combined. And medicine is still diagnosing it through a male lens.
84% of cardiologists report having patients in the past year whose heart disease was misdiagnosed by another physician. Women with a STEMI heart attack have a 59% greater chance of being misdiagnosed compared to men. Women with an NSTEMI — 41% greater chance.
The reason is structural. For decades, we screened, tested, and treated women using a template built for men.
Men's heart attacks announce themselves — the crushing chest pain, the clutched fist, the Hollywood collapse. Women's hearts whisper. Crushing fatigue that feels like wearing a lead vest. Jaw pain written off as TMJ. Nausea blamed on a stomach bug. An ache between the shoulder blades blamed on a long week. Shortness of breath blamed on being out of shape.
For years, medicine called these "atypical" symptoms. They are not atypical. They are female-typical. Half of humanity is not a variant.
And the biology runs deeper than symptoms.
Women have smaller hearts and narrower coronary arteries. Plaque doesn't only clog the big highway vessels — it hides in the microvasculature, the tiny branches feeding the heart muscle itself. A woman can have a heart attack with a completely "clean" standard angiogram.
SCAD — spontaneous coronary artery dissection — occurs 90% of the time in women. Often young, fit women with zero traditional risk factors. It's the leading cause of heart attack in women under 50, accounting for roughly one quarter of all cases in that age group. Most doctors have never diagnosed one.
And some of the most dangerous cardiac risk factors are hidden in women's medical histories where no one thinks to look:
Preeclampsia or gestational hypertension doubles to quadruples lifetime heart disease and stroke risk. Pregnancy is the body's first cardiac stress test — and these complications are early warning sirens, not closed chapters.
Autoimmune disease — lupus, rheumatoid arthritis, psoriasis — far more common in women, turbocharges inflammation and plaque formation at any age.
Cardiovascular disease in women aged 20-44 is projected to surge nearly 50% by 2050.
The youngest patients in my practice keep getting younger.
What every woman should ask her doctor — and what every doctor should be asking:
"Given my pregnancy history, autoimmune status, and family history — what is my full cardiovascular risk?" If they don't ask about preeclampsia or gestational diabetes, volunteer it.
"Should I have an Lp(a) test and a coronary calcium score?" Standard cholesterol panels miss too much. Lp(a) is genetic, one-time, and most women have never been tested.
"My tests came back normal but my symptoms haven't stopped — what's next?" Normal stress tests and angiograms can miss microvascular disease, spasm, and SCAD. Persistent symptoms warrant coronary CT angiography or cardiac MRI.
And if something feels wrong — say these exact words to your doctor: "I am concerned this could be my heart."
That single sentence changes the workup. Do not soften it. Do not apologize for it.
80% of heart disease is preventable. But the playbook has to be built for female biology.
Two decades ago, I wrote one of the first books warning that heart disease was the number one killer of women and that medicine was diagnosing it through a male lens. It was recognized by First Lady Laura Bush at the White House during the early years of the national conversation about women's heart health.
I'm haunted by how much of that book I could republish today unchanged.
The science has advanced. The awareness has grown. But the gap between what we know and what happens in the exam room is still costing women their lives.
Share this with every woman you love — and every doctor who treats them. READ MORE: https://t.co/4LRugiY8q2

[Robert Allotment cat,now helped by Janet & Amanda @AllotmentCat]

(Amanda)
I want to ask you a favour today - if you live in the UK would you please sign this?

It's called a 'petition' and even though I don't understand what it is, I know it's important.

Maybe you could tell other humans about it and ask them to sign it too.

I'll tell you more about the special August thing tomorrow.

Here's the petition -
https://t.co/ZaArb285gN

[Annie Bishop @AnnieBishop123]

We’ve come a long way baby or at least we thought we had. I found this letter in the house that I bought

[Debbie Summers @DeborahSummers]

@MizuumiKami @ActuallyCrab There are at least 40 different dialects in England. Some experts believe there are up to 111. This doesn’t include Wales, Scotland and Northern Ireland.
Therefore, we definitely can ‘comprehend the concept of differing dialects and slang’ https://t.co/w9zk0JARB4

[Trevor Phillips @TrevorPTweets]

My thoughts on the @EHRC guidance laid yesterday; this is not about non-existent "rights". It is about the safety of women - mothers, sisters, wives, daughters. We men need to hear their voices. Virginia Woolf : "Though we see the same world, we see it through different eyes".

My intro on @TimesRadio yesterday:

Where I live there are two different routes to and from the tube station. One, let’s call it Acacia Avenue, is quiet and residential. The other, London Road, is a busy major route with lots of traffic. At all times of the day, I automatically head for Acacia Road. It’s just much nicer.

The women in my family, on the other hand, will never willingly make that walk after dark. They live with an anxiety that most men find it hard to imagine, and frankly, rarely think about unprompted.

Last year 739,000 women were sexually assaulted in Britain. Virtually all such assaults - nine out of ten - are perpetrated by men. One in four women have been attacked at some time in their lives. Acacia Avenue is exactly the sort of place in which most women fear that they become vulnerable, and they are right.

As the author Virginia Woolf once wrote " Though we see the same world, we see it through different eyes".

I think this is the right context in which to understand the furore over the guidance being laid today by the government, over the meaning of the words man and woman when it comes to providing services and facilities in workplaces.

Many men think this is about a rather arcane dispute about who gets to use what loo. For their mothers, sisters, wives and daughters, it isn’t.

In a previous life, as Chair of the Equality and Human Rights Commission, I had a hand in writing this country’s equality laws, in particular the 2010 Equality Act. It never occurred to any of us that there could be any confusion or dispute over the meaning of the words man and woman. But it has taken a decade of campaigning, a Supreme Court judgement and now hundreds of pages of guidance to settle the issue.

This is not about so called trans rights, which are completely unaffected by this guidance, since no-one has ever had the right to walk into a changing room reserved for teenage girls.

What it does mean is that women and girls are guaranteed the protection they deserve, and that their safety, which we spent half a decade drafting law to ensure, is protected.

But the whole business illuminates some serious issues in our politics.

First that many of our institutions, in spite of the fact that they always knew what the right thing to do was, decided to ignore the fears of their women customers and employees, under pressure from noisy pressure groups. Instead, the people who were supposed to be the grown ups behaved as though the law said what campaigners wanted it to say, rather than what it actually said. They settled for what they hoped would be a quiet life.

In a democracy, there’s little point in Parliament deciding anything if the law is then made an ass by activists intimidating bosses in companies, schools, universities and the media into doing something different.

Second, at the heart of the campaign to undermine the Equality Act is an idea that we specifically rejected in 2010, so called self-identification. That is to say, that it should be up to the individual to decide whether they have what’s called a protected characteristic - are you male or female, are you black or white. The problem is that self-ID would destroy the operation of any law against discrimination.

Look, it would almost certainly have been to my advantage as a young man to self-identify as a handsome, white public schoolboy. None of those things is true of me. And at various points I am pretty sure it’s been to my disadvantage. It is certainly statistically likely to have been to my disadvantage.

But according to the logic of those who say that self-ID should be the rule and that anyone should be able to decide for themselves whether they are male or female, black or white or Asian, were I to complain about racial discrimination, it would be difficult for anyone prove that I’d been discriminated against because of my race since anybody to whom I’d lost out could just tell the courts that they too were black.

I know that sounds like Alice in Wonderland but you can google the case where a chap, both of whose parents are white, insisted he should get money from the Arts Council because he so identified with the black struggle that he considered himself black, and everyone should accept his point of view. In the United States and Brazil exactly such outlandish claims have been made and people rewarded to the disadvantage of people actually born into minority families.

I have even been told about firms who, when reporting their gender pay gaps have put men who just happen to like wearing dresses at weekends - nothing wrong with that, let me be clear - into the female column and told their women employees that they really haven’t got anything to moan about because statistically they are paid equally, and they should get back in their box.

So today’s guidance isn’t just another tiresome chapter in culture wars. It is , I hope, a halt to the efforts to undermine one of the most important pieces of legislation on the statute book, by people who, for their own reasons, would prefer us to be living in the 1950s world of Mad Men.

[Rutger Bregman @rcbregman]

This sounds nice, but it's a great way to undermine the welfare state.

The strongest welfare states in the world (the Nordics) tax everyone, including nurses. And they give everyone universal healthcare, childcare, pensions, education in return.

When the middle class has skin in the game, they defend the system. When welfare is 'just for the poor', it becomes a poor program: stigmatized, underfunded, easy to gut.

That's why billionaires keep pushing this idea. The real scandal isn't that this nurse pays $12k.

It's that Jeff Bezos pays $0.

[𝐊𝐁 🇬🇧 @KieranBassinder]

Does anybody from the Kingstanding area of Birmingham recognise this fella?

He stole a lion statue from the front of my nans house at 8:45pm on Friday. It's more than just a lion statue though, as it was bought by my late grandad who sadly passed in January.

Any information about this bloke is appreciated.

Please share, repost, anything you can to push the post and get him recognised and get the statue returned.

#Birmingham #theft #stolen #crime #police

[dave lawrence 🐟🐟🐠 @dave43law]

🤣🤣

[Tiggywinkles @TiggywinklesUK]

❤️🐦Your support helps us give rescued birds, like this beautiful pair of robins, the second chance they deserve.
If this moment made you smile today, please consider adopting a robin at Tiggywinkles 🧡
👉 https://t.co/s77CM6YyP1

[John O'Connell @jdpoc]

Posted elsewhere, posted here for info.

The map of Reform Councils in the UK. So much for 'WE'VE TAKEN OVER THE NATION !!!"

[Debbie Summers @DeborahSummers]

@LBFlyawayhome British Birds

[BladeoftheSun @BladeoftheS]

Caroline Lucas of the Green Party reckons that Water needs to be Renationalised.

RT if you know it has to be.

[Helen Day @LBFlyawayhome]

An observation test for your inner 8-year-old.
Can you spot the 6 creatures hidden in the picture?

From Treasure magazine, 1965
Official answers coming soon

(Even if you don’t reply, could you please ‘like’ or share this one?)

[Doogs 🏴󠁧󠁢󠁳󠁣󠁴󠁿 @Doogsta]

Remember and use this special ballot box if your thinking of voting for Reform UK on Thursday 👍

[Debbie Summers @DeborahSummers]

@qikipedia @sharkincrisis was this you?

[The Receipts UK ♿ @david_hollas]

This is Reform UK's party chairman announcing that a Reform government would deploy state infrastructure, detention centres, as a reward for voting Reform and a punishment for voting Green. Two days before an election. The Electoral Commission should be examining this today.
@ElectoralCommUK

[Wolf @wolfncrisis]

come to think of it, zebra are basically just walking barcodes

[Feargal Sharkey @Feargal_Sharkey]

I need 100,000 signatures to win a parliamentary debate about the ownership of the water industry.

Do your thing internet.

https://t.co/kZz1cXBtz3