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Is Chest Pain A Reliable Heart Attack Sign in Women?
 

Heart attack, or myocardial infarction (MI), is a condition in which the flow of oxygen-rich blood to a section of heart muscle suddenly is blocked and the heart could not get oxygen. It is a leading killer of both men and women in the United States as well as many other countries. More than a million of Americans have heart attacks every year.

There are excellent heart attack treatments that can save lives and prevent disabilities, but the treatment works best when it is given right after symptoms occur. Hence, identifying the correct symptoms is critical.

Some common symptoms of heart attack include discomfort, pressure, or pain in the chest, sweating, and rapid or irregular heartbeats. Nevertheless, Some people can have a heart attack without any symptoms (silent MI). A silent MI can happen to anyone but it is more common among people with diabetes.

During a heart attack, more than three-quarters of men and women will have chest pain or discomfort. Chest pain with exertion is a more common warning sign in men, while women often have other types of symptoms that include shortness of breath, nausea, vomiting, and pain in the back, neck or jaw.

Regarding chest pain, there might be only a few noticeable differences in how men and women feel during heart attack, according to a European study. The study, referred to as APACE (Advantageous Predictors of Acute Coronary Syndrome Evaluation), was published online November 26, 2013 and subsequently in February 2014’s issue of the journal JAMA Internal Medicine.

Researchers from University Hospital Basel in Switzerland and other institutions in Europe examined 796 women and 1679 men over a 6-year period (from April 21, 2006, through August 12, 2012) in Switzerland, Spain and Italy. The patients had gone to hospital emergency departments within 12 hours of experiencing chest pain.

Chest pain in women and men were evaluated based on 34 different criteria, including the pain's location, duration, when it started, severity and precipitating factors. Patients also provided their medical history, had a physical examination and received other diagnostic tests, like an electrocardiogram and a blood test to assess cardiac levels of troponin, a protein released when a heart attack occurs.

Data analyzed revealed that 18 percent of women with chest pain and 22 percent of men with chest pain had experienced a heart attack. However, most of the criteria used to evaluate chest pain did not distinguish a heart attack from other causes of chest pain in women and men. Only 3 out of 34 criteria related to pain duration and intensity appeared to show sex-specific differences.

Pain that lasted 2 to 30 minutes and decreased in intensity reduced the chance that the symptoms were caused by a heart attack in women, whereas for men, the pain of a heart attack could be of short duration. Compared to men, women with heart attack tended to have pain lasting more than 30 minutes.

While the findings confirmed some important differences in symptoms in women and men during a heart attack, the information did not help doctors to differentiate women with a real heart attack from women who are experiencing chest pain from other causes.

Because the wording used by a patient to depict chest pain had only low to moderate accuracy in diagnosing a heart attack, physicians should always conduct an electrocardiogram and a cardiac troponin test so they do not miss patients with MI.

As the results of the study indicated, chest pain might not be a reliable diagnostic tool to swiftly detect a heart attack. The findings, however, should draw attention to the fact that women can also be at risk for heart attack and might spark more research on this topic.

While women might have atypical heart attack symptoms more often than men, it is likely that they also tend to experience different kinds of chest pain. The more understanding in the differences in how men and women experience heart attack, the better doctor could diagnose and provide immediate treatment.

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