Even in the middle of a heart attack, women are less likely than men to think their symptoms are heart-related

Jul 2 2004

Even in the middle of a heart attack, women are less likely than men to think their symptoms are heart-related and more likely to get bad advice from friends or family about seeking medical care, according to new research.

Most people assume that the typical heart attack patient is male, says René Martin, R.N., Ph.D., of the University of Iowa, so women and the people around them tend to look for other explanations of their symptoms, such as stomach problems.

But misreading warning signs can lead to delays in medical care and worse outcomes for heart attack patients, Martin and her colleagues say.

Their work appears in the journal Health Psychology.

Compared to male participants, women in the study said they were more surprised when finally told they had a heart attack, a view consistent with stereotypes about heightened male heart disease vulnerability, Martin says.

In their study of 109 men and 46 women, Martin and her colleagues looked at the patients’ experiences from the time their symptoms began to when they first encountered medical care.

Men and women in the study had comparable medical histories and were equally likely to report the most common symptoms of a heart attack: chest pain, shortness of breath and fatigue. Both men and women most often assumed that gastrointestinal problems caused their discomfort.

Overall, 60 percent of the patients did not realize that their symptoms indicated a heart attack, Martin says.

“But women were significantly less likely than men to attribute their symptoms to cardiac causes,” she says.

Most participants spoke to other laypeople about their symptoms before going to the hospital. Women talked with more of these support people than men did, but the women were less likely to receive suggestions that they were having heart problems. Also, support people less often advised the women to see a doctor or go to the hospital, Martin says.

Patients who did conclude that their symptoms were due to a heart attack cut delays in reaching treatment by half compared with those who assumed a non-cardiac origin to their distress.

Educating the public, especially women and other vulnerable groups, to recognize heart attack symptoms could save lives, the researchers note.

“Interventions that encourage laypeople to label relevant symptoms as potentially cardiac in origin for both men and women may well be worth pursuing because, in the present sample, participants who attributed their symptoms to cardiac causes were significantly faster in making the decision to seek medical attention,” Martin says.

The research was supported by grants from the American Heart Association and the National Institutes of Nursing Research.