Analysis shows: Heart attacks in women often misdiagnosed

Heart attacks often have different causes in women than in men - for example, the type of vascular deposits. Compared with men, women tend to be undertreated and less likely to participate in rehabilitation for heart patients. In addition, risk factors such as high blood pressure and diabetes increase the risk of heart attack more in women than in men. These are the conclusions of the American Heart Association  in the journal Circulation.

Other causes and symptoms

A female heart attack could have different causes, symptoms and outcomes compared with male patients. Differences in risk factors and outcomes are also more pronounced among African-American and Hispanic-American women, the study authors note.

According to experts at the American Heart Association, the number of deaths from heart disease in women has fallen dramatically. This is due to improved therapy and prevention of heart disease, but also to increased public awareness of the issue.

"Despite impressive improvements in preventing cardiovascular deaths over the past decade, women still fare worse than men and heart disease in women remains underdiagnosed as well as undertreated, especially among African American women," said Laxmi Mehta, cardiologist and director of the Women's Cardiovascular Health Program at the Ohio State University.

Great risk of misdiagnosis

Heart attacks caused by blockages in the main arteries leading to the heart can occur in both sexes. But the way the blockages form a blood clot may differ. Compared with men, women may have less serious blockages that do not require stents of any kind; nevertheless, the coronary arteries are damaged, reducing blood flow to the heart.

However, the result is the same: If the heart receives too little blood, a heart attack can occur. What's more, if doctors don't correctly diagnose the cause of a heart attack in women, they're unlikely to prescribe the right therapy. Medical therapies and medications are similar regardless of the reason for the heart attack or the severity of the blockages. Yet women receive less treatment compared to men - despite the proven benefits of medications.

Women experience more complications when trying to restore blood flow because blood vessels are thinner, they are often older when the heart attack occurs and have more risk factors such as diabetes or high blood pressure. Standard remedies are consistently used less in women, leading to poor outcomes. In addition, rehabilitation is less likely to be prescribed. When they are, women are less likely to participate or drop out prematurely.

Different risk factors

While the most common heart attack symptom is chest pain or even malaise in both sexes, women are more likely to have atypical symptoms such as shortness of breath, nausea or vomiting, and back or jaw pain. The severity of risk factors for heart attack also differ between the sexes. For example, high blood pressure is more likely to cause a heart attack in women. If young women suffer from diabetes, their risk of heart disease increases four to five times compared to young men.

African American women suffer more heart attacks than white women in all age categories. Young African American women are also more likely to die during an inpatient hospital stay. African American and Hispanic American women have more heart-related risk factors such as diabetes, obesity, and hypertension at the time of the heart attack. African American women are also less likely to experience important therapies such as cardiac catheterization.

(press release)