Women who suffer heart attacks wait longer to be assessed

Women who suffer heart attacks wait longer to be assessed, admitted and receive treatment than men with the same condition, according to a paper in the latest Journal of Advanced Nursing.

890 patients admitted to coronary care units via casualty departments in six major teaching hospitals in Dublin were studied in detail by a team led by Dr Sharon O'Donnell from the City's Trinity College.

• On average, women were medically assessed 30 minutes after arriving in casualty departments, compared with 20 minutes for men.
• 92 per cent of women received aspirin, after an average of 55 minutes, compared with 95 per cent of men, after an average of 33 minutes.
• Women waited an average of 70 minutes for reperfusion therapy – which restores blood flow to the heart – compared with 52 minutes for men.
• Only 35 per cent of women received reperfusion therapy, compared with 43 per cent of men. 40 per cent of women and 25 per cent of men did not receive the therapy, because healthcare staff stated it was "too late" to be clinically effective.
• The average time it took for women to be transferred to the coronary care unit from the casualty department was three hours and 56 minutes – 54 minutes longer than men.

"Treatment delays experienced by women may limit their potential to achieve maximum benefit from reperfusion therapies, which have been clinically proven to work more effectively when administered early" says Dr O'Donnell.

"This could result in women being exposed to a greater rate of life-threatening complications and less favourable outcomes than their male counterparts.

"The image of the typical male heart attack victim must be corrected in the minds of triage nurses - who carry out initial assessments in casualty departments - and other healthcare staff.

"Better healthcare training and clinical awareness are needed if women who have heart attacks are to receive the same care as men."

Approximately 120 nurses working across the six coronary care units in Dublin, Southern Ireland, took part in the study, completing a 25-item questionnaire for each patient admitted during the one-year study.

The questionnaire used was designed with input from a panel of experts and tested out during two pilot studies.

Only patients who were admitted via the hospitals' casualty departments, who had a confirmed diagnosis of Myocardial Infarction (heart attack) and who were sent to the hospitals' coronary care units were included in the study.

"Our findings do not give reasons for assessment or treatment delays, but they do present factual yet unexplained accounts of the differences experienced by male and female patients" adds Dr O'Donnell.

"We accept that certain Myocardial Infarction presentations are more difficult to assess and that practical, everyday resources and funding issues may exacerbate treatment and decision-making delays.

"However this study does raise important concerns about equitable healthcare practice and we hope that it will prompt further investigation and discussion, particularly on the issues surrounding women who suffer heart attacks."

The research was funded by the Ireland's Health Research Board.