It is well-known that people who experience a heart attack often develop left-sided chest pain. This pain is often associated with nausea, difficulty breathing and excess sweating.
Now a study shows that this classic presentation of heart attacks does not always occur in young women. Far fewer younger women than men who develop a heart attack experience chest pain.
Overall, men have a much higher incidence of heart attacks, but under the age of 55, it is women who are more likely to die from one. The reason for this is that women may not display the classic features of chest pain and hence the diagnosis is missed.
In the study conducted by Dr. John Canto of the Watson Clinic and Lakeland Regional Medical Center in Florida, over 1,143,000 patients were assessed of whom 42 % were women. The study just published in the Journal of the American Medical Association (JAMA), stresses the importance of healthcare professionals recognizing that an individual is having a heart attack, even if they don't have chest pain or discomfort. (1)
In this study, researchers looked at patients who visited more than 1000 hospitals for heart attacks. There observed some striking differences between women and men under the age of 55. Overall, close to 42 percent of women did not experience chest pain compared to 30 percent of men. And even when admitted, women were more likely to die.
The authors indicated that it is critical for doctors to realize this atypical presentation in women with a heart attack. Patients that do not have chest pain while suffering a heart attack, generally tend to experience it later, and consequently are treated much less aggressively.
This often leads to a high mortality rate, when compared to men experience typical chest pain of a heart attack.
Fortunately, heart disease in women under the age of 55 is very rare. It is widely believed that the female sex hormone, estrogen, offers a protective effect to the heart. After menopause, a woman’s risk of a heart attack quickly catches up with men. (2)
The importance of this study is that all women, young or old, should not disregard symptoms of chest pain. Even if it is mild, it is important to seek help from the nearest emergency room and be seen by a physician. Heart attacks do not have any discriminatory property and can present itself in many ways.
Some women tend to believe that heart attacks only occur in men and others often attribute the mild chest discomfort to acid reflux or indigestion.
Because mild symptoms may be overlooked by inexperienced staff, it is important for women to tell health care providers to rule out a heart attack. Sometimes being proactive can save one’s life.
1. Canto J. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012 Feb 22;307(8):813-22.
2. Vaccarino V, Sex differences in mortality after acute myocardial infarction: changes from 1994 to 2006. Arch Intern Med. 2009 Oct 26;169(19):1767-74.
Reviewed February 27, 2012
by Michele Blacksberg RN
Edited Jessica Obert