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07 May 2008
A global study of heart attack patients has found that women often exhibit different symptoms to men and receive different - and sometimes slower - treatment as a result.
The findings, included in the Global Registry of Acute Coronary Events, are based on data from 25,755 men and women in 14 countries who had a heart attack or chest pain episode between 1999 and 2006.
Analysis of the data by researchers from the University of Michigan Cardiovascular Center found that women were twice as likely as men to have "normal" or "mild" results of an angiogram, which allows doctors to see blockages in the heart's blood vessels.
Such blockages can be a major cause of heart attacks and chest pain, but in normal or mild results no single blockage takes up more than 50 per cent of any one blood vessel.
The study authors believe that lack of serious blockages may have something to do with how women were treated and their ongoing health after medical intervention.
They found that among patients with the same level of coronary artery disease, women were significantly less likely than men to receive drugs called beta blockers, statins and ACE inhibitors - all of which are considered crucial to preventing further heart episodes.
In addition, no matter how serious their blockages, women were less likely to receive an angioplasty or a stent to open up their blood vessels.
Researchers believe women may have blockages in smaller blood vessels that can't be seen on conventional angiograms or their blockages may have been fleeting, disappearing before the images can be made.
"We need to find out whether women might have blockages that are 'invisible' on angiograms," said senior author Kim Eagle, Albion Walter Hewlett professor of cardiovascular medicine .
Symptom differences were also found. While 94 per cent of men and 92 per cent of women reported they felt chest pain, women patients who didn't cite chest pain were more likely to experience "atypical" symptoms such as nausea and jaw pain.
Commenting on the results, study co-author Lisa Jackson, an assistant professor of cardiovascular medicine at the University of Michigan, said: "We have two education challenges ahead, based on these data: educating women that they should seek immediate attention for both the classic heart attack symptoms and atypical sudden symptoms, and educating physicians that non-obstructive coronary artery disease is still disease and needs to be treated seriously."
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