One study has warned that women who experience heart attacks are more likely than men to have symptoms of chest pain misdiagnosed by doctors as anxiety or stress.
Researchers from Spain analyzed the treatment of 41,828 hospitalized patients with chest pain and compared the treatment they received.
Women were almost twice as likely as men to suffer a case of acute coronary syndrome (including a heart attack) initially misdiagnosed.
But doctors weren’t the only ones misjudging the circumstances, the team found, with women more likely than men to wait more than 12 hours before seeking help.
Meanwhile, a 2014 study found that women with heart attacks are more likely to have to wait longer to be examined in hospitals than men.
One study has warned that women who suffer heart attacks are more likely than men to have a symptom of chest pain misdiagnosed by doctors as anxiety or stress.
“Our findings suggest a gender gap in the first assessment of chest pain, with the likelihood of an underestimated heart attack in women,” said Gemma Martinez-Nadal, author of the document at the Hospital Clínic de Barcelona, Spain.
“The low suspicion of heart attack occurs in both women and physicians, leading to higher risks of late diagnosis and misdiagnosis.”
In his study, Dr. Martinez-Nadal and colleagues studied the experiences of a total of 41,828 patients admitted to a hospital emergency department with chest pain between 2008 and 2019.
Of the patients, 42% were women and the mean age was 65 for women and 59 for men.
For each subject, the researchers collected information about their heart attack risk factors (including whether they were obese or had high blood pressure) and the initial diagnosis from the doctor handling the case.
“We had the doctor’s first impression of whether chest pain had a coronary cause or other origin, such as anxiety or musculoskeletal disease,” Dr. Martinez-Nadal explained.
These first impressions are recorded before exams, such as blood tests, and are given based on the patient’s medical history, a physical exam, and a measurement of cardiac activity by electrocardiogram (ECG).
The researchers found that women were significantly more likely to show up at the hospital more than 12 hours after the onset of chest pain, which occurred in 41% of women compared to 37%. of men.
“This is worrisome, as chest pain is the main symptom of reduced blood flow to the heart (an‘ ischemia ’) because an artery has narrowed,” Dr. Martinez-Nadal said.
“It can cause a myocardial infarction that needs prompt treatment,” he added, referring to the disease better known as heart attack.
“According to the doctor’s first impression, women were more likely than men to be suspected of a non-ischemic problem,” Dr. Martinez-Nadal said. Pictured, a patient with chest pain (stock image)
The team found that doctors were significantly more likely to attribute chest pain to acute coronary syndrome (a general term for conditions such as heart attacks involving reduced blood flow to the heart) if the patient was a man.
Specifically, in 93% of cases where the ECG could not provide a definitive diagnosis, physicians suspected acute coronary syndrome in 44.5% of men, but only in 39% of women.
In addition, this trend was maintained regardless of the number of heart attack risk factors that patients had or whether they presented with typically indicative chest pain.
Acute coronary syndrome was initially misdiagnosed in 5% of women, but only in 8% of men.
“According to the doctor’s first impression, women were more likely than men to be suspected of a non-ischemic problem,” Dr. Martinez-Nadal said.
“Risk factors such as hypertension and smoking should instill a higher suspicion of possible ischemia in patients with chest pain.”
“But we observed that women with risk factors were even less likely than men to be classified as ‘probable ischemia.'”
“Heart attack has traditionally been considered a male disease and has been poorly studied, misdiagnosed and abused in women, who may attribute symptoms to stress or anxiety,” Dr. Martinez-Nadal concluded.
“Both women and men with chest pain need to seek medical help urgently.”
The full conclusions of the study are presented at the congress of the European Society of Cardiology of Acute CardiVascular 2021, which is being held practically from 13 to 14 March 2021.