Would you know if you were having a heart attack? More importantly, would your doctor correctly diagnose you? Possibly not, according to a recent study by the University of Leeds.
Using their national heart attack registry Myocardial Ischaemia National Audit Project (MINAP) researchers in the UK found that approximately one-third of heart attack patients are initially misdiagnosed.(1)
The study looked at approximately 600,000 heart attack patients over the course of nine years. The number of patients initially misdiagnosed was 198,534.
Two Main Types of Heart Attacks
The two main types of heart attacks are STEMI and NSTEMI.(1)
Non-ST segment elevation myocardial infarction, or NSTEMI, is the more common of the two. It is a partial blockage of one or more arteries. Women whose final diagnosis was NSTEMI were 41 percent more likely to be misdiagnosed than men.
ST segment elevation myocardial infarction, or STEMI, is the total blockage of the main artery which carries oxygenated blood throughout the body. Women whose final diagnosis was STEMI had a 59 percent greater chance of misdiagnosis than men.(1)
Both types of heart attack cause serious injury to the heart. However, women who were misdiagnosed had a 70 percent increased risk of death after 30 days, compared to those who were diagnosed accurately. Men who were misdiagnosed had similar risk of death.(1)
Symptoms of a Heart Attack
STEMI and NSTEMI present similarly, with similar symptoms:(2)
- Chest pain
- Breathing difficulty
Who Has Heart Attacks?
“Typically, when we think of a person with a heart attack, we envisage a middle aged man who is overweight, has diabetes and smokes,” said Dr. Chris Gale, associate professor of Cardiovascular Health Sciences at the University of Leeds, who was one of the researchers.(1)
In fact, heart attack is an equal opportunity killer, and the number one cause of death among men and women in the United States.(3)
Risk factors for heart attack include:(3)
- Overweight and obesity
- Poor diet
- Physical inactivity
- Alcohol abuse
How Can Women Be Accurately Diagnosed?
Medicine is a man’s world, with clinical drug trials often excluding women as I wrote in "Your Prescription May be Sexist."
It turns out, even a critical test for heart attacks has previously been biased against women.
The University of Leeds research has resulted in adapted criteria for reading the troponin test — a routine test for diagnosing heart attack — for female heart attack diagnoses. By fine-tuning the troponin test, more women receive a correct diagnosis.(1)
If you find yourself in the hospital with heart attack symptoms, ask your doctor if he or she is using criteria specifically for women when reading the troponin test.
If you are brushed off, keeping asking until someone answers. The question just may save your life.
Reviewed September 12, 2016
by Michele Blacksberg RN
Edited by Jody Smith
1) Heart attacks in women more likely to be missed. leeds.ac.uk. Retrieved September 8, 2016.
2) NSTEMI vs STEMI. NSTEMI.org. Retrieved September 8, 2016.
3) Women and Heart Disease Fact Sheet. CDC.gov. Retrieved September 8, 2016.