It is not new
information that the male sex has been overly represented in medical research.
From symptom presentation to the effect of different medications on the body,
everything has been centered around men. As a consequence, women have silently
suffered longer wait times to the Cath lab and being sent home with the
diagnosis of anxiety for far too long. Finally, we have entered a time period
where women have begun to be the center of research.
Recently, the
International Journal of Cardiology published a study in Sweden titled “Gender
differences in symptom presentation of ST-elevation myocardial infarction- An
observational multicenter survey study.” This study was a multicenter
observational study that focused on answering whether there are gender differences
in symptom presentation in ST-elevation myocardial infarctions (STEMIs).
Participants were enrolled within 24 hours after admission to reduce recall
bias. Of the results collected, the most important finding was that there was a
strong and independent association between female gender and non-chest pain
presentation. In fact, the most common presentation was shoulder pain, as well
as throat/neck pain. Women were also three times as likely to have associated
nausea.
These findings
are important for several reasons. First off, while older studies have found
gender differences in chest pain prevalence, more recent ones have shown no
differences. What is important to note is that of the mentioned recent studies,
none restricted the inclusion to STEMI patients, but had a mixed inclusion of acute
coronary syndrome (ACS) patients. Studies have shown that in a mixed MI cohort,
a higher percentage of women than men will have NSTE ACS, and the clinical
presentation of STEMI and non-ST-elevation (NSTE) ACS has been found to differ
with more severe symptoms in STEMI. Given these findings, it is imperative that
more and larger studies are done to understand, acknowledge and spread
awareness to symptom presentation in women to decrease the time it takes from
initial symptom presentation to cath lab.
Nishita Saraiya DUCOM 2020
Source:
Lawesson, S et al. (2018). Gender
differences in symptom presentation of ST-elevation myocardial infarction- An
observational multicenter survey study. International
Journal of Cardiology, 264(4)7-11.
