|
medpundit |
||
 |
 |
|
Tuesday, November 04, 2003Lack of significant chest pain may be a major reason why women have more unrecognized heart attacks than men or are mistakenly diagnosed and discharged from emergency departments. 'Many clinicians still consider chest pain as the primary symptom of a heart attack.' Belinda Linden, of the British Heart Foundation said the study 'exposes the need for women to be aware of the wide range of possible symptoms of a heart attack such as chest and throat discomfort, breathlessness, sweatiness, weakness or dizziness. 'Tiredness, as a symptom, is important when it is severe or unusual. The study was a retrospective one that asked women what their symptoms were months after the fact: Researchers recruited 515 women diagnosed with a heart attack and discharged from five different medical sites in Arkansas, North Carolina and Ohio within the previous four to six months. The women were age 66 on average, and 93 percent were Caucasian, 6.2 percent black and 0.4 percent Native American. Data collection occurred over three years. ..... About 95 percent of women reported having new or different symptoms more than a month before their heart attacks that resolved after their heart attacks. This led them, in retrospect, to believe that these symptoms were related to the subsequent heart attack. The most common early symptoms were: unusual fatigue -- 70 percent; sleep disturbance -- 48 percent; shortness of breath -- 42 percent; indigestion -- 39 percent and anxiety -- 35 percent. Only 30 percent reported chest discomfort before their heart attack. They described the discomfort in terms like aching, tightness and pressure – not pain, McSweeney said. [emphasis mine] It isn't uncommon for people to look back in retrospect and attribute earlier symptoms to their current disease, even when those symptoms have nothing to do with their illness. Here's how the abstract breaks down the results: The most frequent prodromal symptoms experienced more than 1 month before AMI were unusual fatigue (70.7%), sleep disturbance (47.8%), and shortness of breath (42.1%). Only 29.7% reported chest discomfort, a hallmark symptom in men. Notice that those are "prodromal symptoms," that is, symptoms experienced in the month prior to the discovery of their heart problems. And actually, there's no evidence,other than the author's belief, that chest pain is the "hallmark" of impending heart disease in men. (see here.) In fact, men who present with new onset fatigue, weakness, or shortness of breath should also be evaluated for the possibility of coronary artery disease. But, when you talk about presenting with an acute onset of heart disease - that is, the day of the heart attack - those other vague symptoms take a back seat to chest pain/discomfort: The most frequent acute symptoms were shortness of breath (57.9%), weakness (54.8%), and fatigue (42.9%). Acute chest pain was absent in 43%. Women had more acute (mean, 7.3±4.8; range, 0 to 29) than prodromal (mean, 5.71±4.36; range, 0 to 25) symptoms. Clever way to bury that information. A full 57% of women presented with chest pain, just like men do when they're having heart attacks. And more of the women had the acute symptoms than the vaguely recalled prodromal symptoms. Things aren't as different between the sexes as sex-biased researchers would like us to believe. posted by Sydney on 11/04/2003 08:42:00 AM 0 comments 0 Comments: |
|
