Women less likely to get treatments for heart attack
If a woman came to your ED with atypical symptoms and then obtained normal results from an angiogram, you might assume that she was not having a heart attack. However, that is a dangerous assumption to make, according to a new study.1
Researchers examined data from the Global Registry of Acute Coronary Events on 25,755 men and women who had a heart attack or chest pain episode between 1999 and 2006. Here are key differences the researchers found:
- Women were more likely to have atypical symptoms.
Although 94% of men and 92% of women reported chest pain, female patients who didn't have chest pain were more likely to experience symptoms such as nausea and jaw pain.
"These women need to be assessed, particularly those with multiple risk factors such as hypertension or diabetes, as they may be experiencing an acute coronary event," says Elizabeth A. Jackson, MD, MPH, one of the study's authors and assistant professor of medicine in the University of Michigan Health Systems' Division of Cardiovascular Medicine.
- Women were twice as likely as men to have "normal" or "mild" results on an exam of their heart's blood vessels, with no single blockage taking up more than 50% of any one blood vessel.
Patients who have had a prior cardiac catheterization that shows nonobstructive coronary artery disease (CAD) still can have recurrent chest pain or acute coronary syndrome, says Jackson. "This means that some of them should have medications such as aspirin or statins, depending on their risk factors."
- Women were significantly less likely than men to receive beta-blockers, statins, and angiotensin-converting enzyme (ACE) inhibitors. "This was one of the interesting findings. There is continued disparity among women and men in regard to effective cardiac medications, in particularly those with more severe CAD," says Jackson.
Reference
- Dey S, Flather MD, Devlin GP, et al. Sex-related differences in the presentation, treatment and outcomes among patients with acute coronary syndromes. The Global Registry of Acute Coronary Events. Heart May 2008. Doi:10.1136/hrt.2007.138537.
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