Women, especially those that are younger, are more likely to suffer a heart attack without painful chest symptoms. A new study suggests they also are less likely to survive.
The finding is particularly concerning since many female patients do not experience chest pain with a heart attack, and the lack of pain could cause delays in seeking treatment, a later diagnosis and less aggressive treatment.
Dr. John G. Canto, a study author from the Watson Clinic and Lakeland Regional Medical Center, found that there were differences between men and women of all ages in regards to experiencing chest pain, and mortality rates, but that they diminished as the patients aged.
Younger women under the age of 45 were most likely not to experience chest pain with a heart attack. That group also was more likely to die as a result of a heart attack. By the age of 65, the gender gap had closed substantially.
During the observational study, researchers reviewed the records of more than one million heart attack patients through the National Registry of Myocardial Infarction between 1994 and 2006. Nearly half were women, and 35.4 percent of the patients reported chest pain.
Investigators found that 40 percent more women reported no chest pain or discomfort following a heart attack. They also were 42 percent more likely to die in the hospital.
The in-hospital mortality rate was 10.3 percent for men and 14.6 percent for women. Younger women without chest pain were also more likely to die as compared to young men who did not experience chest pain, though the gender gap narrowed with advancing age.
The finding could have implications for treating heart attack patients, especially those who do not report chest pain or discomfort.
The study was recently published in the Journal of the American Medical Association.
Coronary artery disease is the leading cause of death in the United States and in the rest of the world. Estimates point to almost one half of all middle aged men and one third of all middle aged women in the United States developing some form of CAD. The primary symptom of angina, commonly known as chest pain, occurs when the artery is almost completely blocked.
Plaques made up of cholesterol and fibrous tissue lodge in the walls of the arteries that supply blood to the heart. Slow growth of the plaques can cause chest pain as they restrict blood flow to the heart muscle, and complete closure or rupture of the plaque can cause a myocardial infarction, commonly known as a heart attack, with resulting disability or death. CAD is primarily a disease of diet and habits, with the greatest risk factors coming from smoking, high blood pressure, high cholesterol, and diabetes.