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Gender Differences in Symptoms of Myocardial Ischaemia

Resource type
Date created
2011-09-14
Authors/Contributors
Abstract
AimsBetter understanding of symptoms of myocardial ischaemia is needed to improve timeliness of treatment for acute coronary syndromes (ACS). Although researchers have suggested sex differences exist in ischaemic symptoms, methodological issues prevent conclusions. Using percutaneous coronary intervention (PCI) balloon inflation as a model of myocardial ischaemia, we explored sex differences in reported symptoms of ischaemia.Methods and resultsPatients having non-emergent PCI, but not haemodynamic instability or left bundle branch block or non-acute coronary occlusion, were prospectively recruited. Pre-procedure, descriptions of pre-existing symptoms were obtained using open-ended questioning. Inflation was maintained for 2 min or until moderate discomfort or clinical instability occurred. During inflation, subjects were exhaustively questioned about their symptoms. Concurrent ECG data were collected. The final sample was 305 [39.7% women; mean age 63.9 (±10.6)]. No sex differences were found in rates of chest or typical ischaemic discomfort, regardless of ischaemic status. Women were significantly more likely to report throat/jaw discomfort [odds ratio: 2.91; 95% confidence interval: 1.58–5.37] even after statistical adjustment for clinical and demographic variables.ConclusionThis prospective study with ECG-affirmed ischaemia found no statistically significant differences in women's and men's rates of chest and other typical symptoms during ischaemia, although women were more likely to experience throat and jaw discomfort. Currently both popular press and some patient education materials suggest women experience myocardial ischaemia differently from men. Steps to ensure women and health professionals are alert for the classic symptoms of myocardial ischaemia in women, as well as men, may be warranted.
Document
Identifier
DOI: 10.1093/eurheartj/ehr358
Published as
Mackay, M.H., Ratner, P.A., Johnson, J.L., Humphries, K.H., Buller, C.E. Gender differences in symptoms of myocardial ischaemia. European Heart Journal 32 (24). 2011. 3107–3114. https://doi.org/10.1093/eurheartj/ehr358
Publication title
European Heart Journal
Document title
Gender differences in symptoms of myocardial ischaemia
Date
2011
Volume
32
Issue
24
First page
3107
Last page
3114
Publisher DOI
10.1093/eurheartj/ehr358
Copyright statement
Copyright is held by the author(s).
Scholarly level
Peer reviewed?
Yes
Language
English
Member of collection
Download file Size
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