Chest Pain Differences Between Men and Women

Chest pain characteristics were very similar for women and men experiencing heart attacks

(RxWiki News) Chest pain can be a sign that the heart may not be working properly. Could the characteristics of that pain point to different diagnoses for men and women?

A group of researchers set out to answer that question by studying men and women who went to the hospital with chest pain.

These researchers asked patients about the different aspects of the chest pain, like location, duration and whether it was sudden. They also noted whether each patient was diagnosed with a heart attack or not.

They found that there were some significant differences between the types of chest pain that women and men experienced. However, among patients diagnosed with heart attacks, there were fewer differences.

These researchers concluded that sex-specific characteristics of chest pain alone could not adequately help doctors to diagnose women experiencing a heart attack.

"Talk to your doctor about signs of a heart attack."

Maria Rubini Gimenez, MD, of University Hospital Basel in Switzerland, led this study on chest pain differences between men and women.

Chest pain is the most common symptom used to diagnose heart attacks, although not all heart attack patients experience chest pain.

The authors of this study noted that previous research has revealed some differences in the symptoms that men and women report when they are having a heart attack.

To see whether women experienced different heart attack symptoms than men, these researchers looked at data from 2,475 patients who came to the hospital with chest pain. Of these patients, 796 (32.2 percent) were women.

This study took place between April 21, 2006 and August 12, 2012. Adult patients who came to the emergency room with chest pain symptoms consistent with a possible heart attack were enrolled in the study.

Dr. Gimenez and colleagues took note of what time the chest pain began and when it had peaked. The patients also underwent a clinical assessment, during which medical professionals took blood tests, gave physical examinations and measured the participants' pulses.

These researchers also looked for 34 different characteristics of the chest pain, including its location, the size of the pain area, the duration, relieving factors and more.

Lastly, the researchers recorded the diagnosis that the patients received.

A total of 18 percent of the women and 22 percent of the men were diagnosed with a heart attack.

Of the 34 different chest pain characteristics, 11 significantly differed between women and men.

Women were more likely to report pressure, shortness of breath, pain radiating to the throat or back and pain lasting longer than 30 minutes.

Among the patients who were diagnosed with a heart attack, however, most of the characteristics were fairly similar.

Five of the characteristics did significantly differ between women and men: Women reported less frequent radiation to the right arm and shoulder and more frequent radiation to the back. Women also were more likely to experience pain longer than 30 minutes.

However, the researchers concluded that the sex differences in chest pain characteristics alone were not enough to be a single tool used to diagnose heart attacks. They suggested using other clinical tests for diagnostic purposes.

"This is an important and quite unique study in the cardiovascular field, focusing on cardiac symptom presentation, and as a result of its methodology, trial execution, and results, lead to publication in the influential Journal of the American Medical Association (JAMA)," said Mohan Sathyamoorthy, MD, Chief of the Cardiovascular Division at Baylor All Saints Medical Center.

Dr. Sathyamoorthy continued with, "What we learned from this study is something that we have implicitly recognized in cardiac practice for years. Women present with different types of cardiac symptoms than men, and that we as a medical community, need to be carefully tuned in to recognize these differences, particularly in the setting of a heart attack. Several of these differences were highlighted in the study, which ultimately concluded that though differences existed between men and women, a good majority of the symptoms experienced during a 'true heart attack' are remarkably similar between men and women. The results of this study are impactful as they lend further understanding in helping us recognize 'true heart attacks' in women."

This research was published in JAMA Internal Medicine on November 25.

This study was funded by research grants from the Swiss National Science Foundation, the Swiss Heart Foundation, the Cardiovascular Research Foundation Basel, the University of Basel and the University Hospital Basel.

Some of the authors reported receiving research grants and speakers' honoraria from various institutions, including those that funded this study.

Review Date: 
November 25, 2013