I mean, for guys: you suddenly feel like an elephant is standing on your chest = this is just nature’s way of telling you your heart is seizing up. Women, according to a NIH survey:
Major symptoms during the heart attack include:
Shortness of breath - 58%
Weakness - 55%
Unusual fatigue - 43%
Cold sweat - 39%
Dizziness - 39%
Any or several of which could be innocuous daily occurences in a woman’s life.
What is it in women’s physical and chemical body structure that causes their symptoms to be so less straightforward than men’s?
Bump? I’d really like to know as well. This is a hot topic lately, but nobody really says why women are so different in this regard. Maybe they don’t know?
My friend’s mom died of a heart attack and they both thought that she just had the stomach flu or had eaten something bad until she collapsed and died an hour later. The only symptom she had was vomiting.
Of course, lots of men present with atypical cardiac symptoms, classic chest pain is not universal. I once had a guy come in full arrest, thought he’d tweaked his left shoulder on a new job cuz it was sore for a couple of days, went down like a bag of hammers
I would say not that women’s symptoms are so “misleading”, but say why don’t we routinely include such symptoms as possible indicators of MI? The elephant on your chest is the “classic” symptom, but the list of possible ones is long–as a nurse, those pts of mine experiencing an MI have very rarely complained of that elephant, no matter their gender. Societal factors could play a role as well–women aren’t told (this is changing, thank goodness) to be alert for such symptoms–breast health is stressed, for example.
Atypical chest pain is fairly common in males as well as females. The problem was (and has gotten better recently) that HCPs weren’t picking up on women’s symptoms and/or were attributing them to other causes. It wasn’t all that long ago that a woman presenting with chest pain in the ER would be assumed to have gallbladder issues or indigestion, pneumonia or whathaveyou-not an MI. Sorry I don’t have a cite, but I’m on my way to work.
There was a great article in The New Yorker a few weeks back about the way doctor’s think. It did not address this issue directly, but essentially it said that most docs “make up their minds” diagnostically quite quickly-and not always to the benefit of the pt, and that might also play a role here.
Just a guess, but it might be because women typically aren’t included in studies or drug trials as frequently as men are so they tend not to know as much about how symptoms and side effects can be different in women. Awhile back I read an article that outlined the problem of excluding women in drug trials and called for guidelines to include more women for more accurate results. While the article focuses mainly on the effects of new drugs, I wonder if that doesn’t also affect the knowledge of how the disease in general affects women.
Is there some sort of “at home test” to determine if one should get checked out? I’m not running to the doctor every time I get any of these symptoms unless they are quite severe or last for 5+ days.
My mom died of a heart attack when I was eighteen. It seemed extremely sudden… until a few years later, when we realized she’d been having those symptoms for over a week before she died. Nobody knew- she just thought she was feeling a bit under the weather.
I wish I could remember where I read the speculation that the difference had to do with the obstruction happening in relatively smaller blood vessels. Just as “effective” in the long run at starving heart muscle for oxygen, but not as dramatic. IANAD, just my WAG.
I’ve seen people having a heart attack – their only symptom was hiccups. Some have no symptoms at all. Many ERs would routinely do ECGs on patients presenting with indigestion, fatigue, dizziness, sweating, shortness of breath or anxiety. I can’t say I’ve ever done an ECG only for sleep disturbance or depression – but you could justify it.
I’d be interested to know why the patterns are different.
I can’t offer a cite, but I believe that this was true in the past, mostly corrected now, but still within the cultural inertia of the profession.
Having said that I’ll repeat that there’s no sign or symptom that’s infallible. I’ve seen a cardiologist take a pt to the cath lab for no better reason than the ER nurse said “it just smells cardiac to me, doc” and proceed to find a heart attack about to happen. Sure they would have admitted the pt for obsevation anyway, and her condition probably would have declared itself, but it was better to get there sooner.