29 Aug “Typical” Chest Pain More Common in Women With Heart Attack

MedicalResearch.com Interview with:
Amy Ferry
Cardiology Research Nurse
Centre for Cardiovascular Science
The University of Edinburgh

MedicalResearch.com: What is the background for this study?

Response: The fourth universal definition of myocardial infarction now recommends the use of sex-specific diagnostic criteria. This approach has revealed a population of patients with myocardial infarction (predominantly women) who were previously unrecognised. The impact of these diagnostic criteria on the presentation and clinical features of men and women with suspected acute coronary syndrome is unknown. 

MedicalResearch.com: What are the main findings?

Response: Chest pain was experienced by 93% of both men and women with myocardial infarction. Additionally, presenting symptoms met the definition of ‘typical’ in 77% of women compared to 59% of men with myocardial infarction. This study concluded that typical symptoms are more common and have greater predictive value in women than men with myocardial infarction, whether diagnosed using sex-specific or uniform criteria.  

MedicalResearch.com: What should readers take away from your report?

Response: There remains a prevailing culture within medicine that women are more likely to present with atypical symptoms. Our concern is that by incorrectly labelling women as having atypical presentations, we may be encouraging doctors and nurses not to investigate or initiate treatment for coronary heart disease in women. Both men and women present with an array of symptoms, but our study has shown that clusters of so called typical symptoms in women should raise high suspicion of a heart attack.

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: These findings could be confirmed in a larger, more ethnically more diverse population.

Women have lower one-year survival rates after heart attacks than men. Under-diagnosis may play a key role in this disparity. As part of aprogram of research led by our British Heart Foundation funded research programme (@HighSTEACS or www.highsteacs.com) we aim to improve the treatment and outcome of both men and women with suspected heart attacks.

I have no disclosures. 

Citation:

Presenting Symptoms in Men and Women Diagnosed With Myocardial Infarction Using Sex‐Specific Criteria
Amy V. Ferry, Atul Anand,Fiona E. Strachan, Leanne Mooney, Stacey D. Stewart,
Lucy Marshall, Andrew R. Chapman, Kuan Ken Lee, Simon Jones, Katherine Orme, Anoop S. V. ShahnNicholas L. Mills
Originally published 20 Aug 2019
https://doi.org/10.1161/JAHA.119.012307
Journal of the American Heart Association. 2019;8:e012307

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Last Updated on August 29, 2019 by Marie Benz MD FAAD