Women, and your docs: Take this advice to heart

Women, more often than men, experience atypical chest pain, or none at all, when having a heart attack a disparity that significantly increases their risk of dying while in the hospital, reports a new, large study just published in the Journal of the American Medical Association. The findings may have important implications for clinical practice.

To examine the relationship between a patient s age, sex, and the type of heart attack (myocardial infarction, or MI) symptoms they experience, researchers examined data from the National Registry of Myocardial Infarction. In their analysis of close to 1.15 million patients, over 481,000 of whom were women, the researchers found that, compared to men, women are 40 percent less likely to have chest pain at diagnosis and have a 42 percent higher in-hospital mortality rate. They also found that, while the disparities between men and women existed in all age groups, the degree of difference diminished with increasing age: In effect, the youngest women who have an MI are the least likely to have chest pain; they also have the highest mortality.

Patients and practitioners need to be cognizant of the fact that women present with heart attacks in a different, less predictable manner than most men, says ACSH's Dr. Gilbert Ross. What might initially be perceived as nausea, indigestion, or shortness of breath can turn out to be a heart attack in women. And while such atypical symptoms can signal an MI in men also, this sort of presentation is clearly and dangerously more common in women.