Acute MI symptoms similar among men, women
Symptoms of acute MI, including chest pain, were similar among men and women, according to new results published in the Go Red for Women issue of Circulation.
Although previous studies have suggested that women are less likely to experience chest pain associated with acute MI, the results of the VIRGO study suggest that the rates for men and women are closer than previously reported.
However, the researchers wrote that compared with men, women were more likely to report symptoms other than chest pain and were less likely to have their symptoms attributed to heart disease.
“Sex differences in symptom presentation for acute MI have been shown in older populations, but less is known about potential sex differences in self-reported symptoms, perception of symptoms and self-reported care-seeking behavior in young patients with acute MI,” Judith Lichtman, PhD, from the department of chronic disease epidemiology at the Yale School of Public Health and colleagues wrote. “Given the increased mortality associated with premature acute MI in women, it is critical to fully investigate the number and type of acute symptoms of heart disease in young patients and explore how symptom recognition influences patients’ care-seeking behaviors and early interactions with healthcare providers, as well.”
To determine sex differences in acute MI symptoms in younger patients, researchers interviewed 2,985 patients (2,009 women) aged 18 to 55 who were hospitalized for acute MI and participated in the VIRGO study at 103 U.S. hospitals.
A total of 87% of women and 89.5% of men presented with chest pain, defined by the researchers as pain, pressure, tightness or discomfort.
The researchers found that women were more likely to present with at least three associated symptoms than men (women, 61.9%; men, 54.8%; P < .001).
An adjusted analysis showed that women with STEMI were more likely to present without chest pain compared with men (OR = 1.51; 95% CI, 1.03–2.22).
Additionally, women were more likely than men to perceive symptoms as stress/anxiety (20.9% vs. 11.8%, P < .001) but less likely to attribute symptoms to muscle pain (15.4% vs. 21.2%, P = .029).
Lichtman and colleagues found that more women than men sought medical care for similar symptoms before their hospitalization (29.5% vs. 22.1%; P < .001). However, 53% of women reported that their provider did not think these symptoms were heart-related, compared with 37% of men (P < .001).
“Women presented with a greater number of non-chest pain symptoms, and although the total number of additional symptoms may not be noteworthy, the presentation of chest pain within the context of multiple symptoms may influence the prompt recognition of heart disease and initial actions on the part of provider,” the researchers wrote. “Our results highlight the challenge for providers to identify heart disease in this young cohort traditionally considered low-risk, even though they may have multiple risk factors and often have a family history of heart disease.”– by Dave Quaile
Disclosure: Lichtman reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.