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Heart Attack Symptoms: Sex Difference?

Symptoms of Heart Attack Don't Always Include Chest Pain -- for Men or Women

By Miranda Hitti
WebMD Health News

Reviewed By Louise Chang, MD

Dec. 10, 2007 -- Researchers today announced that they see no need to draft a different list of heart attack symptoms in women than in men.

While women are less likely than men to report chest pain or discomfort during a heart attack, that difference doesn't warrant a sex-specific rewrite of heart attack symptoms, according to a report published today in the Archives of Internal Medicine.

The report includes this list of heart attack symptoms for both sexes:

  • Chest discomfort that may feel like pressure, squeezing, fullness, or pain. The discomfort may last for more than a few minutes or come and go.
  • Discomfort in other areas of the upper body including one or both arms, the back, neck, jaw, or stomach.
  • Shortness of breath, which may or may not accompany chest discomfort.
  • Other symptoms such as breaking out in a cold sweat and experiencing nausea or lightheadedness.

Call for emergency medical care at the first sign of those symptoms. The stakes are too high to wait and see if the symptoms ease or if they aren't due to a heart attack.

Heart disease is the leading cause of death for men and women in the U.S.

Heart Attack Symptoms in Women

Today's report on women's heart attacks is based on a review of 69 studies conducted over 35 years.

The studies focused on acute coronary syndrome, defined as a heart attack or unstable angina (heart-related chest pain).

Each study was designed differently. Some only focused on women; some included men, too.

The reviewers found that among acute coronary syndrome patients, more than a third of women -- 37% -- and more than a quarter of men -- 27% -- didn't report chest pain or discomfort.

But most women and most men did report chest pain or discomfort from their heart attack or unstable chest pain.

Age may have affected the results. Older patients were less likely to report chest pain or discomfort, and women typically had their heart attack or chest pain a decade after men did.

More studies are needed to probe sex differences in the symptoms of heart attacks. But for now, Canto's team isn't ready to draw up a sex-specific symptom list.

Heart Attack Symptoms? Call 911

Women tend to wait longer than men to seek medical attention for possible heart attack symptoms. No one should delay such care, warns Kathleen Dracup, RN, DNSc.

Many women and men don't experience chest pain or discomfort during a heart attack, Dracup notes in an Archives of Internal Medicine editorial.

"One might wonder about the wisdom of instructing patients about a 'typical' presentation that creates the expectation that chest pain or discomfort should be present before taking the drastic action of calling emergency services," writes Dracup.

She suggests letting men and women know that heart attack symptoms can vary and may include nausea, shortness of breath, and sweating with or without chest pain or discomfort.

Dracup works for the School of Nursing at the University of California, San Francisco.

SOURCES: Canto, J. Archives of Internal Medicine, Dec. 10/24, 2007; vol 167: pp 2405-2413. Dracup, K. Archives of Internal Medicine, Dec. 10/24, 2007; vol 167: p 2396. News release, National Heart, Lung, and Blood Institute, National Institutes of Health.

© 2007 WebMD Inc. All rights reserved.








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