Yale study: Women’s heart attack symptoms more often dismissed than men’s
NEW HAVEN — Younger women who report symptoms such as shortness of breath, chest palpitations or indigestion — and who later have heart attacks — are more likely than men to have the symptoms dismissed as not heart related, according to a study led by the Yale School of Public Health.
The study included patients 55 years old and younger, who have not been studied as often as older patients, according to a press release. The 2,009 women and 976 men were interviewed after they were hospitalized for a heart attack, said Judith H. Lichtman, associate professor and chairwoman of the Department of Chronic Disease Epidemiology at the School of Public Health, and lead author of the study, which was published online Monday in the journal Circulation.
The major symptoms of those suffering acute myocardial infarctions, or heart attacks, were chest pain, pressure, tightness and discomfort, which were reported by 90 percent of both men and women, the study, which involved more than 100 hospitals, found.
But women were more likely than men to report additional symptoms such as indigestion, shortness of breath, palpitations or pain in the jaw, neck or arms. Lichtman said 29 percent of women sought care for these symptoms but that 53 percent who did were told by their health care providers that their symptoms were likely not heart-related.
“Some of them thought it was stress and anxiety … and the impression they got from their care provider was that it wasn’t related to their heart,” Lichtman said.
Men, 22 percent of whom described additional symptoms such as muscle pain or indigestion, were less likely to seek care before actually suffering a heart attack, she said.
“A greater proportion of women were seen for similar symptoms prior to being hospitalized, but 53.4 percent were told it may not be related to their heart as opposed to 36.7 percent of men who sought care,” Lichtman said.
“This raises what I would consider a missed opportunity,” she said. “My guess is that because women in this age group are considered to be less at risk for heart disease, their symptoms may not have been recognized.”
Lichtman said that, after chest pain and other chest-related symptoms, “the most common symptom for both groups was indigestion and acid reflux.”
Earlier studies have shown that women are less likely to complain of chest pain and more likely to report other symptoms, and that they are more likely to die in the hospital from a heart attack than men, according to a press release.
The study found, Lichtman said, “if in this early period before this hospitalization, if heart attack symptoms were suspected, there was no sex difference in workup for a heart attack.”
“An important point is that these young women all had multiple cardiac risk factors” before suffering a heart attack, said Dr. Gail D’Onofrio, co-author of the study and chairwoman of the Department of Emergency Medicine at Yale School of Medicine, in the release.
“Thus, when young women with multiple risk factors visit their doctor with any chest discomfort or other symptoms that may be associated with ischemic heart disease, they should have the appropriate workup.”
Data was used from Yale’s Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients (VIRGO) study, which involves other institutions as well.
Circulation is a journal of the American Heart Association.