When younger adults show up in the emergency room with chest pain, women wait longer to be seen and get less attention than men, according to a paper to be presented this weekend at an American College of Cardiology conference.
The study looked at 29 million ER visits for chest pain by those age 18 to 55, more than half of which were women. Although men and women were just as likely to arrive by ambulance, women waited 11 minutes longer to be evaluated and were significantly less likely to get an electrocardiogram. Guidelines recommend patients with heart attack symptoms be seen with 10 minutes.
“Time is very important when you’re treating heart attacks,” said Darcy Banco, MD, an internal medicine resident at NYU Langone Health and the study’s lead author. “The longer people wait, the worse their outcomes can be.”
Women’s heart-related symptoms differ
The study did not look at why the discrepancy exists, but Banco believes that it was less likely to be discrimination than the fact that clinicians are less likely to suspect a heart attack in a younger woman.
“We, as health care providers, should continue to learn about how best to triage and diagnose patients with heart attacks, particularly among those who have historically been under-diagnosed or under-treated,” Banco said. “We are learning that heart attacks take many forms. We need to continue to raise awareness and make sure all patients are diagnosed and treated properly, even if they’re not the ‘classic’ demographic for a heart attack. [This knowledge] will help us improve care for all.”
Banco will be presenting her study on Saturday, May 15 at the American College of Cardiology’s 70th Annual Scientific Session, which is being held virtually.
While chest pain is a common symptom of heart attack in both sexes, women can have other symptoms that might not suggest a heart attack. Other studies have also found that women may have a lower “normal” blood pressure than men, and that hypertension in women is often misdiagnosed as menopause. Another ACC study found that women with heart disease do better with female doctors.
Banco said women should trust their instincts when they experience symptoms that could signal a heart attack.
“Women should seek care right away if they experience new chest discomfort, difficulty breathing, nausea, vomiting, fatigue, sweating or back pain, as these could all be signs of a heart attack,” she said. “The most important thing a woman can do is to seek medical care if she is worried and to ask specific questions of her doctor.”