Heart Attack Symptoms: Closing the Gender Gap

Reported October 27, 2009

(Ivanhoe Newswire) -- When it comes to heart attack symptoms, the gender difference may not be nearly as great as we've been led to believe.

In a Canadian study, researchers found no gender difference in rates of chest discomfort or other 'typical' symptoms such as arm discomfort, shortness of breath, sweating, nausea, indigestion-like symptoms, and clammy skin.

"Both the media and some patient educational materials frequently suggest that women experience symptoms of a heart attack very differently from men," cardiac nurse Martha Mackay, a Canadian Institutes of Health Research clinical research fellow and doctoral student at the UBC School of Nursing, was quoted as saying. "These findings suggest that this is simply not the case."

Mackay and her team studied 305 patients undergoing angioplasty -- which briefly causes symptoms similar to a heart attack.

While both women and men may experience typical or non-typical symptoms, the major difference was that female patients were more likely to experience both the classic heart attack symptoms plus throat, jaw, and neck discomfort.

So why have studies shown that female cardiac patients do not experience chest discomfort or other 'typical' symptoms as frequently as men?

Mackay thinks communication breakdown may be a factor. "In today's fast-paced hospital emergency departments, doctors must try to gather information about a patient's symptoms quickly and efficiently," she explained. "Unfortunately this may sometimes mean they ask about a limited 'menu' of symptoms and some may be missed."

She advises female patients to tell their doctor all of their symptoms -- not just the ones they are asked about.

She recommends that doctors and nurses avoid 'closed' questions when assessing patients. For example, instead of simply asking "Are you having chest pain," a question that leads to a yes or no answer, adding "Are you having any other discomfort?" may elicit information that could help make the diagnosis easier and more accurate.

"Where women are concerned, some extra probing could result in a speedier and more complete diagnosis," Mackay said. This is critical, because treatment of heart attack must be given within a few hours after symptoms commence in order to be effective, so any delay in making the diagnosis could lead to a poorer response to treatment.

Early, accurate diagnosis is especially important since women are 16 per cent more likely than men to die after a heart attack.

Heart and Stroke Foundation spokesperson Dr. Beth Abramson was quoted as saying that while women may describe their pain differently, the most common symptom in women is still chest pain. She says that the challenge is that women are less likely to believe they are having a heart attack and are more likely to put off seeking treatment.

"Heart disease and stroke are the leading cause of death of women in Canada," said Dr. Abramson. "Being aware of the warning signs and acting on them quickly could save your life - or the life of someone you love - and minimize the damage to your health."

The warning signals of a heart attack for women and men are pain, shortness of breath, nausea, sweating and fear. Fear is the most dangerous of all, as it may involve denial, causing the victim to delay seeking treatment.

Mackay emphasized, "Clear educational messages need to be crafted to ensure that both women and healthcare professionals realize the classic symptoms are equally common in men and women."

SOURCE: Presented at the Canadian Cardiovascular Congress, Edmonton, Alberta, October 26, 2009