A study has warned that women who have heart attacks are more likely than men to have symptoms of chest pain misdiagnosed as anxiety or tension.
Researchers from Spain analyzed the treatment of 41,828 patients admitted to the hospital with chest pain and compared the treatment they received.
Women were nearly twice as likely as men to have a case of acute coronary syndrome – including a heart attack – that was initially misdiagnosed.
But doctors were not the only ones who misjudged the circumstances, the team found that women waited more than twelve hours more before asking for help.
A 2014 study, meanwhile, found that women with heart attacks are also more likely to have to wait longer to be examined in hospitals than men.
A study warned (example) that women who experience heart attacks are more likely than men to misdiagnose their symptoms of chest pain as anxiety or stress.
“Our findings point to a gender gap in the initial evaluation of chest pain, with the likelihood of a heart attack in women being underestimated,” said author Gemma Martinez-Nadal of the Hospital Clinic in Barcelona, Spain, said.
“The low suspicion of a heart attack occurs in both women themselves and in doctors, leading to greater risks of late diagnosis and misdiagnosis.”
In their study, Dr Martinez-Nadal and colleagues studied the experiences of a total of 41828 patients admitted to a hospital’s emergency department with chest pain between 2008 and 2019.
Of the patients, 42 percent were women, and the mean age was 65 years for the women and 59 for the men.
For each topic, the researchers gathered information about their risk factors for a heart attack – including whether they are obese or have high blood pressure – and the initial diagnosis of the doctor handling the case.
“We had the first impression of the doctor on whether the chest pain had a cause of the heart or another origin, such as anxiety or a musculoskeletal complaint,” said Dr. Martinez-Nadal explains.
Such first impressions are recorded before examinations such as blood tests, and are rather given based on the clinical history of the patient, a physical examination and an electrocardiogram (ECG) measurement of heart activity.
The researchers found that more than 12 hours after the onset of chest pain, women were significantly more likely to present themselves in the hospital – this was found in 41 percent of women compared to 37 percent of men.
“This is worrying, as chest pain is the main symptom of reduced blood supply to the heart – an ‘ischemia’ – because an artery has narrowed,” said Dr Martinez-Nadal.
“It can lead to a myocardial infarction that needs to be treated quickly,” she added, referring to the condition more commonly known as a heart attack.
“According to the doctor’s first impression, there is a greater chance that women than men are suspected of a non-ischemic problem,” says Dr Martinez-Nadal. In the photo a patient with chest pain (stock image)
The team found that physicians were significantly more likely to attribute chest pain to acute coronary syndrome – an umbrella term for a condition such as heart attacks involving reduced blood flow to the heart – if the patient was a man. .
In the 93 percent of cases in which the ECG could not provide a definitive diagnosis, doctors specifically suspected that acute coronary syndrome was present in 44.5 percent of men, but only 39 percent of women.
In addition, this trend was maintained regardless of the number of risk factors for heart attacks that patients had and whether they typically had an indication of the breast.
Acute coronary syndrome was initially misdiagnosed in 5 percent of women, but only 8 percent of men.
“In the doctor’s first impression, there was more chance that women than men were suspected of a non-ischemic problem,” said Dr Martinez-Nadal.
“Risk factors such as high blood pressure and smoking should increase the risk of ischemia in patients with chest pain.”
“But we noticed that women with risk factors were increasingly less likely to be classified as ‘probable ischemia’.”
“Heart attack is traditionally considered a male disease and is underemphasized, underdiagnosed and undertreated in women who can attribute symptoms to stress or anxiety,” Dr Martinez-Nadal concluded.
“Both women and men with chest pain need urgent medical attention.”
The full findings of the study will be presented at the conference of the European Society of Cardiology’s Acute CardioVascular Care 2021, which will be held virtually from 13 to 14 March 2021.