Nadia Khan
Relying on traditional symptoms for heart attacks in young people and women can lead to dangerous misdiagnoses, according to a study involving UBC researchers.
Published in this month’s issue of JAMA Internal Medicine, the study evaluated more than 1,000 Canadians — aged 55 or less — who were hospitalized for acute coronary syndrome (ACS), the umbrella term used to describe heart attacks and angina, which is a lack of blood and oxygen going to the heart due to an artery blockage.
Investigators found that one out of five women in the study did not experience chest pain when having a heart attack and that women were less likely to experience chest pain compared with men.
“Previous research has shown that women aged less than 55 years are more likely to have their heart attacks and angina misdiagnosed in the ER than men, and they have higher risk of death,” says Nadia Khan, an Associate Professor in the Department of Medicine and a scientist with the Centre for Health Evaluation and Outcome Sciences at St. Paul’s Hospital. “We wanted to take a closer look at the symptoms that young women and men were having with heart attacks and angina.”
The heart attacks women experienced without chest pain were no less severe compared with heart attacks in women with chest pain. Furthermore, patients without chest pain had fewer symptoms overall but their ACS was not less severe. The diagnosis of ACS, therefore, depended on detailed cardiological assessments.
“We need to remind ourselves that even without chest pain, something serious could still be happening,” says Dr. Khan, the first author on the article.
The authors say that at-risk individuals and families and health care professionals should look for the following symptoms when determining ACS: weakness, feeling hot, shortness of breath, cold sweats, and pain in the left arm or shoulder. These were the most common symptoms reported by women and men who did not experience chest pain.
The study also involved Providence Health Care and the McGill University Health Centre (MUHC), and made possible by funding from the Canadian Institutes of Health Research and the Heart and Stroke Foundation.