Women receive help for heart attacks later than men

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By Amy Norton
HealthDay Reporter

MONDAY, May 10, 2021 (HealthDay News) – When young women land in emergency rooms with chest pain, wait longer and receive less treatment than their male counterparts, according to a preliminary study.

Through a federal survey of U.S. hospitals, researchers found that younger women with chest pain were treated less urgently than men their age. This includes a lower probability of receiving standard tests to diagnose one heart attack.

Chest pain can have several causes, including minor problems such as muscle tension i acid reflux.

But it is also the most common symptom of a heart attack in both women and men, said study co-author Dr. Harmony Reynolds, a cardiologist at NYU Langone Health in New York City.

It is unclear why young women were treated differently for chest pain. But some implicit biases from some medical professionals could be working, Reynolds said. The old stereotype that heart attack is a “human disease” still persists.

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The study is not the first to uncover a gender gap in the treatment of heart attack. Others have shown that women receive less of the drugs recommended for post-heart attack care and have a higher risk of dying within a few years of a heart attack.

The new findings add to the overview, in part, by focusing on younger adults, said lead researcher Dr. Darcy Bank, resident in internal medicine at NYU Langone.

Although heart attacks are more common among older adults, they also affect younger ages.

In fact, Banco said, some “concerning trends” have been seen in recent years among young Americans, especially women.

A study published in February found that since 2010, heart disease deaths have increased among U.S. women under 65. The researchers noted that “epidemics are worsening.” obesity i type 2 diabetes as probable culprits.

And over the past two decades, about a third of women hospitalized for a heart attack were under 55, according to the American College of Cardiology (ACC).

The current study focused on emergency care, using data collected from U.S. hospitals between 2014 and 2018.

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It was found that women were just as likely as men to arrive by ambulance, but their cases were less often judged as “emerging.” On average, women waited about 11 more minutes to receive care.

This may seem like a small difference, but the minutes are important in heart attack treatment, Banco noted.

According to medical guidelines, all patients arriving in the emergency room with possible symptoms of a heart attack should receive an electrocardiogram (ECG) within 10 minutes. Electrocardiograms record the electrical activity of the heart and are the standard initial test for diagnosing a heart attack.

However, young women in this study of 18- to 55-year-olds were less likely to receive an electrocardiogram: about 74%, compared with 79% of men. Consultants also saw women less frequently, such as a cardiologist (8.5% vs. 12%), or were placed on cardiac control (25% versus 30%).

Bank will present the results on Saturday at the ACC’s annual meeting, which will be held online. Studies reported at meetings are generally considered preliminary until they are published in a peer-reviewed journal.

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The finding did not surprise Dr. Ileana Piña, a volunteer medical expert with the American Heart Association.

“The perception that women don’t have heart disease is still out there,” said Piña, a clinical professor of medicine at Central Michigan University.

He said examples abound in which women’s symptoms are nullified as stress or indigestion. Although heart disease is the number 1 killer in both men and women, Piña said.

What should women do?

First, it is important to know the symptoms of a heart attack and act on them, the three doctors said.

Keep in mind, according to Reynolds, that heart attacks often cause discomfort (rather than crushing pain) in the chest. And women are more likely than men to suffer from some other symptoms, such as shortness of breath, nausea, and pain moving in the jaw or upper back.

When some symptoms appear, some studies have found that women often delay the 911 call.

“We will call everyone except ourselves,” Piña said.

But, as the current study shows, even when women with chest pain call an ambulance, their care may not be the same as that of men.

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Again, the three doctors received similar advice: ask questions. Tell emergency providers that you are concerned that you have a heart attack and that you want to know what tests have been done.

Piña recommended asking the cardiologist on duty.

“I think we have to be a little picky,” he said.

More information

The American Heart Association has more advantages women and heart disease.

SOURCES: Darcy Bank, MD, MPH, resident in internal medicine, NYU Langone Health, New York; Harmony Reynolds, MD, associate professor of medicine at New York City’s Grossman School of Medicine; Ileana Piña, MD, MPH, clinical professor, medicine, Central Michigan University, Mount Pleasant, Michigan, and volunteer medical expert, American Heart Association, Dallas; presentation, online meeting, American College of Cardiology, May 15, 2021



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