After the fourth visit to her GP in just a matter of months – and this time prescribed antibiotics for a suspected chest infection – Julia Ferris hoped she would start to feel better.
asserted
she → prescribe → infection
But her symptoms continued to get worse.
asserted
symptoms → continue → ?
‘I was constantly tired, felt dizzy and there were occasions where I needed to stop and catch my breath when walking,’ says Julia, 57, a retired nurse practitioner in mental health.
asserted
Julia → feel → health
She didn’t think much of it at first because it ‘didn’t stop me working’.
asserted
me → think → it
‘But by the end of the day, I was shattered.
asserted
I → shatter → day
There was just enough energy to sort dinner – but then I’d collapse on the sofa and have to go to bed early
asserted
I → be → bed
,’ recalls Julia, who lives in Peterborough, Cambridgeshire, with her husband, Keith, 58, a welder fabricator.
asserted
who → recall → husband
‘I wasn’t overweight or unfit but thought perhaps my age meant I was slowing down and getting lazy as a result.
asserted
I → think → result
Maybe I needed vitamins, or to go to the gym.
asserted
I → need → gym
But the symptoms meant I didn’t have the energy even to do that.’
asserted
I → mean → that
Initially, she and Keith thought she might have a virus – the first GP she saw concurred, and told her to rest.
uncertain
she → think → her
But within three weeks or so – and still feeling drained – she went back to her GP, twice.
asserted
she → feel → GP
Diagnosed with post-viral syndrome and told to simply ‘give it time’, she still didn’t feel right.
asserted
she → diagnose → time
A nurse even suggested she was depressed.
uncertain
she → suggest → ?
Julia knew that wasn’t the case, so went back a week later and saw another nurse – who this time gave her the antibiotics.
asserted
who → know → antibiotics
But once again, this didn’t help – and Julia’s symptoms got worse.
asserted
symptoms → help → ?
She was now having to take days off work because she felt so tired and the breathlessness became more regular.
asserted
breathlessness → have → work
‘I was constantly tired, felt dizzy and there were occasions where I needed to stop and catch my breath when walking,’ says Julia Ferris, 57
‘I loved walking our springer spaniel, Buster, but I was starting to struggle to do that
asserted
I → feel → that
,’ says Julia, who has two sons, aged 27 and 23.
asserted
who → say → sons
In April 2019, she went back to her GP practice – for a sixth visit over ten weeks.
asserted
she → go → weeks
This time she happened to see a different GP, who examined her chest using a stethoscope.
asserted
who → happen → stethoscope
She detected a ‘heart murmur’ – this is characterised by a blowing or swishing sound between the usual heartbeats because of blood flowing abnormally through the heart valves – and she referred Julia for an echocardiogram, an ultrasound that checks the heart’s structure and function.
asserted
that → detect → structure
Before this scan, she was told the results would take two weeks.
asserted
results → tell → weeks
‘But immediately afterwards they said I needed to see my doctor the next day – so I knew something was seriously wrong,’ she says.
asserted
she → say → doctor
‘I still thought I’d just been pushing myself too hard, though.’
asserted
I → think → myself
Yet it still took another four months before Julia received a diagnosis: severe symptomatic aortic stenosis – a type of heart valve disease affecting the main valve in the heart that can be life-threatening if left untreated.
asserted
that → take → heart
Half of those living with it die within two years, according to recent figures.
uncertain
Half → live → figures
Even after her diagnosis, it was another two months before she had life-saving, open-heart surgery in the November to have the faulty valve replaced.
asserted
valve → have → November
And, even then, terrified that her symptoms were deteriorating rapidly (by this stage she couldn’t even brush her teeth without becoming exhausted), she faced paying £35,000 to have the surgery done privately.
asserted
surgery → terrify → 35,000
In a condition where prompt diagnosis is essential, Julia’s continued misdiagnosis and treatment delays could have been disastrous.
uncertain
misdiagnosis → continue → condition
Heart valve disease affects 1.5 million people in the UK – it occurs when one or more of the four heart valves don’t work correctly; the valve fails to open or close as it should, affecting blood flow through the heart.
asserted
it → affect → heart
The most commonly affected is the aortic valve, because it controls blood flow from the left ventricle, the heart’s main pumping chamber, into the aorta and ensures that oxygen-rich blood moves out to the body.
asserted
blood → affect → body
The causes range from congenital defects, damage to the valves (after a heart attack, for instance), ageing (wear and tear of the valve tissues) – or risk factors such as diabetes or high cholesterol which accelerate the hardening or calcification of the valves.
asserted
which → range → valves
But only 28 per cent of the women estimated to develop severe aortic stenosis will receive treatment, compared to 51 per cent of men, according to a new report by the charity Heart Valve Voice and others.
uncertain
cent → estimate → charity
They also found that only 36 per cent of all operations to repair or replace the damaged valve were carried out on women in 2024/2025, despite the fact that women are the majority of those over 65 who are affected.
asserted
who → find → 65
Quite simply, women with severe aortic stenosis are less likely to be diagnosed compared with men, more likely to be untreated, more likely to deteriorate through lack of diagnosis – and ultimately more likely to die from a condition that is both detectable and treatable.
asserted
that → diagnose → condition
‘The reasons for this are multiple,’ says Dr Clare Appleby, a consultant cardiologist at Liverpool Heart and Chest Hospital who contributed to the new report.
asserted
who → say → report
‘Firstly, there is still the belief amongst some healthcare professionals that heart disease is a men’s health issue.
asserted
disease → be → professionals
In fact, annually, cardiovascular disease kills more women over 65 than any other condition.
asserted
disease → kill → condition
Indeed, heart disease kills more than twice as many women as breast cancer.
asserted
disease → kill → cancer
…and 75 more, not listed.
The Aporia
