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Health Watch: Women & Heart Attacks

Dr. Brett Parkinson with Mountain Medical breaks down this study.

___________________________________________________________In a recently published article in the Archives of Internal Medicine entitled “Symptom Presentation of Women With Acute Coronary Syndromes–Myth vs. Reality,” researchers, funded by a grant from the National Institutes of Health, report what many physicians and patients have suspected for years: Even in a heart attack, women are different from men. Examining 35 years of research from multiple studies, the investigators reported that between 30 and 37 percent of women do not experience chest discomfort during a heart attack, or

myocardial infarction (MI). Of course, the overwhelming majority of men report chest symptoms during an acute MI. The study authors also concluded that older people are also more likely to have an MI without chest discomfort. As women are on average 10 years older than men at the time of their initial MI, it is somewhat difficult to determine the degree to which gender, in an of itself, contributes to difference in symptoms.

Overall, however, chest pain is till the most significant symptom in both women and men. It is important that the public be aware of both the classic symptoms of myocardial infarction, as well as those symptoms that may be peculiar to women.


• Squeezing chest pain; pressure or tightness in chest

• Pain radiating to shoulder, arm of neck

• Shortness of breath

• Sweating

• Heartburn/indigestion, with or without nausea

• Sudden dizziness or brief loss of consciousness


• Indigestion or gas-like pain

• Loss of appetite

• Dizziness, nausea or vomiting

• Unexplained weakness, fatigue

• Discomfort between shoulder blades; jaw pain –Recurring chest discomfort –Sense of impending doom

Since absence of chest discomfort is a strong predictor for missed diagnosis and treatment delay, women should be on the lookout for the more subtle, less obvious symptoms of heart attack. Because of these atypical symptoms women seek medical care later than men. Moreover, women are less likely than men to have typical EKG findings. Two other sobering facts: Women are less likely to receive life-saving, clot busting treatment in the emergency setting, and are slightly more like to die in the hospital.


Oxygen deprivation to the heart, which if left untreated, leads to death of the cardiac muscle

An interruption of the blood supply to the heart. This is caused by blockage of the vessels that supply blood to the heart, the coronary arteries. Blockage occurs secondary to an accumulation of fatty deposits, also known as plaque, which build up inside the coronary arteries. If the plaque breaks open, the body’s self-repair system springs into action, forming a clot. The clot can block the artery, cutting off the blood supply and the oxygen it carries to the heart.


• Aspirin (can be given before the patient arrives at the hospital)

• Intravenous administration of drugs to dissolve clots (thrombolytic therapy)

• Angioplasty (balloon at the end of a catheter threaded into the artery is inflated, widening the vessel to restore blood flow)

• Stent placement (small wire-mesh tube inserted via catheter into artery to keep it open).



Mountain Medical Physician Specialists is a partnership of over 50 board-certified radiology and vascular professionals providing patients along the Northern Wasatch Front with the latest imaging and vascular care available. Mountain Medical professionals specialize in vascular surgery, vascular and interventional radiology, CT, neuroradiology, orthopedic imaging, MRI, women’s imaging, ultrasound, nuclear medicine and body imaging. For more information visit

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