Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Current Cardiology Reports
Published in: Current Cardiology Reports 2/2015

01-02-2015 | Ischemic Heart Disease (D Mukherjee, Section Editor)

Chest Pain Characteristics and Gender in the Early Diagnosis of Acute Myocardial Infarction

Authors: Garima Arora, Vera Bittner

Published in: Current Cardiology Reports | Issue 2/2015

Login to get access

Abstract

Acute myocardial infarction is one of the leading causes of cardiovascular disease mortality in both men and women. Chest pain, which is often described as chest pressure, tightness, or a squeezing sensation, is the most frequent symptom in patients presenting with acute myocardial infarction. Although the diagnosis of acute myocardial infarction is often based on typical changes on a surface electrocardiogram and on changes in cardiac biomarkers, there is a need to better recognize and understand the impact of sex on symptoms among patients presenting with acute coronary syndrome or acute myocardial infarction. We briefly review the pathophysiology of ischemic symptoms, discuss potential mechanisms for variation in ischemic symptoms by sex, and summarize recent publications that have addressed sex differences in ischemic symptoms.
Literature
1.
Go AS, Mozaffarian D, Roger VL, et al. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;129(3):e28–292.CrossRefPubMed
2.
Canto JG, Rogers WJ, Goldberg RJ, et al. Association of age and sex with myocardial infarction symptom presentation and in-hospital mortality. JAMA. 2012;307(8):813–22.CrossRefPubMed
3.
Gupta A, Wang Y, Spertus JA, et al. Trends in acute myocardial infarction in young patients and differences by sex and race, 2001 to 2010. J Am Coll Cardiol. 2014;64(4):337–45.CrossRefPubMed
4.
Thygesen K, Alpert JS, Jaffe AS, et al. Third universal definition of myocardial infarction. J Am Coll Cardiol. 2012;60(16):1581–98.CrossRefPubMed
5.
Nawar EW, Niska RW, Xu J. National hospital ambulatory medical care survey, emergency department summary. Adv Data. 2005;2007(386):1–32.
6.
Yeh RW, Sidney S, Chandra M, et al. Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med. 2010;362(23):2155–65.CrossRefPubMed
7.
Meischke H, Larsen MP, Eisenberg MS. Gender differences in reported symptoms for acute myocardial infarction: impact on prehospital delay time interval. Am J Emerg Med. 1998;16(4):363–6.CrossRefPubMed
8.
Chen W, Woods SL, Puntillo KA. Gender differences in symptoms associated with acute myocardial infarction: a review of the research. Heart Lung J Crit Care. 2005;34(4):240–7.CrossRef
9.
Shin JY, Martin R, Suls J. Meta-analytic evaluation of gender differences and symptom measurement strategies in acute coronary syndromes. Heart Lung J Crit Care. 2010;39(4):283–95.CrossRef
10.
Gibbons RJ, Balady GJ, Bricker JT, et al. ACC/AHA 2002 guideline update for exercise testing: summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Update the 1997 Exercise Testing Guidelines). Circulation. 2002;106(14):1883–92.CrossRefPubMed
11.
Arslanian-Engoren C, Engoren M. Physiological and anatomical bases for sex differences in pain and nausea as presenting symptoms of acute coronary syndromes. Heart Lung J Crit Care. 2010;39(5):386–93.CrossRef
12.••
Kreatsoulas C, Shannon HS, Giacomini M, et al. Reconstructing angina: cardiac symptoms are the same in women and men. JAMA Intern Med. 2013;173(9):829–31. This study shows that there are no differences in anginal symptoms between men and women with stable CAD. CrossRefPubMed
13.
Mackay MH, Ratner PA, Johnson JL, et al. Gender differences in symptoms of myocardial ischaemia. Eur Heart J. 2011;32(24):3107–14.CrossRefPubMed
14.
Tamura A, Naono S, Torigoe K, et al. Gender differences in symptoms during 60-second balloon occlusion of the coronary artery. Am J Cardiol. 2013;111(12):1751–4.CrossRefPubMed
15.••
Devon HA, Rosenfeld A, Steffen AD, et al. Sensitivity, specificity, and sex differences in symptoms reported on the 13-item acute coronary syndrome checklist. J Am Heart Assoc. 2014;3(2):e000586. This is a prospective multi-center study that sought to determine the influence of gender on symptoms during ACS. CrossRefPubMedCentralPubMed
16.••
Rubini Gimenez M, Reiter M, Twerenbold R, et al. Sex-specific chest pain characteristics in the early diagnosis of acute myocardial infarction. JAMA Intern Med. 2014;174(2):241–9. This prospective study shows that differences in chest pain characteristics by gender are small and are not powerful enough to be used clinically in the diagnosis of AMI. CrossRefPubMed
17.
Khan NA, Daskalopoulou SS, Karp I, et al. Sex differences in acute coronary syndrome symptom presentation in young patients. JAMA Intern Med. 2013;173(20):1863–71.PubMed
18.
Eastwood JA, Johnson BD, Rutledge T, et al. Anginal symptoms, coronary artery disease, and adverse outcomes in Black and White women: the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE) study. J Women’s Health. 2013;22(9):724–32.CrossRef
19.
Reis SE, Holubkov R, Conrad Smith AJ, et al. Coronary microvascular dysfunction is highly prevalent in women with chest pain in the absence of coronary artery disease: results from the NHLBI WISE study. Am Heart J. 2001;141(5):735–41.CrossRefPubMed
20.
Marroquin OC, Holubkov R, Edmundowicz D, et al. Heterogeneity of microvascular dysfunction in women with chest pain not attributable to coronary artery disease: implications for clinical practice. Am Heart J. 2003;145(4):628–35.CrossRefPubMed
21.
Murthy VL, Naya M, Taqueti VR, et al. Effects of sex on coronary microvascular dysfunction and cardiac outcomes. Circulation. 2014;129(24):2518–27.CrossRefPubMed
22.
Burg MM, Edmondson D, Shimbo D, et al. The ‘perfect storm’ and acute coronary syndrome onset: do psychosocial factors play a role? Prog Cardiovasc Dis. 2013;55(6):601–10.CrossRefPubMedCentralPubMed
Metadata
Title
Chest Pain Characteristics and Gender in the Early Diagnosis of Acute Myocardial Infarction
Authors
Garima Arora
Vera Bittner
Publication date
01-02-2015
Publisher
Springer US
Published in
Current Cardiology Reports / Issue 2/2015
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI
https://doi.org/10.1007/s11886-014-0557-5

Other articles of this Issue 2/2015

Current Cardiology Reports 2/2015 Go to the issue

Ischemic Heart Disease (D Mukherjee, Section Editor)

Bypass Grafting Versus Percutaneous Intervention in Multivessel Coronary Disease: the Current State

Hypertension (WB White and AJ Peixoto, Section Editors)

Managing Hypertension with Ambulatory Blood Pressure Monitoring

Ischemic Heart Disease (D Mukherjee, Section Editor)

Statins and Cognitive Function: an Updated Review

Ischemic Heart Disease (D Mukherjee, Section Editor)

Health Resource Variability in the Achievement of Optimal Performance and Clinical Outcome in Ischemic Heart Disease

Echocardiography (JM Gardin, Section Editor)

Echocardiographic Evaluation of Left Ventricular Diastolic Function: an Update

Echocardiography (JM Gardin, Section Editor)

The Role of Echocardiography in Hypertrophic Cardiomyopathy