Heart Attack Signs Vary

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Both men and women can experience "atypical" heart attack symptoms, as well as classic signs of a heart attack.

People need to know that so they seek emergency help immediately for those symptoms. But some patients may have mistaken beliefs about heart attack differences in men and women, say Jill Quinn and Kathleen King of the University of Rochester's nursing school in New York.

Quinn, PhD, RN, CS-ANP, is an assistant professor specializing in cardiovascular nursing. King, PhD, RN, FAAN, is a professor with a focus on women and heart disease.

"Expectations that only women experience atypical symptoms can lead to confusion for both men and women, resulting in delay [of seeking treatment]," they told the Second International Conference on Women, Heart Disease, and Stroke, which is underway in Orlando, Fla.

Heart Attacks in Men vs. Women

Everyone needs to take care of his or her heart. Heart disease is a leading killer for both sexes. A heart attack is its most visible sign, says the American Heart Association (AHA). Last year, the AHA predicted that 700,000 people in America would have their first heart attack in 2004. Another 500,000 heart attack survivors were expected to have another heart attack last year.

Women aren't the only ones who can have "atypical" heart attack symptoms. Men can, too, say Quinn and King.

Likewise, classic heart attack symptoms don't only affect men. Women can experience the same well-known warning signs, such as:

  • A crushing, squeezing, or burning pain, pressure, or fullness in the center of the chest. The pain may radiate to the neck, one or both arms, the shoulders, or the jaw. The chest discomfort lasts more than a few minutes or can go away and return.
  • Shortness of breath, dizziness, nausea, chills, sweating, or weak pulse
  • Cold and clammy skin, gray pallor, or a severe appearance of illness
  • Fainting (rare)

    Not all of these symptoms occur during a heart attack, but because every second counts, if you experience them call 911 immediately, says the American Heart Association.

    Quinn and King studied 41 women and 59 men who had suffered heart attacks. The study centered on heart attack symptoms and any delays in seeking medical care.

    Most participants were white. The women were about 70 years old, compared with the men's average age of 60. More men were current or former smokers -- 81%, compared with 56% of the women. No gender differences existed for a history of angina (chest pain), coronary artery disease, high blood pressure, diabetes, previous heart attacks, or cholesterol.

    Here's how the participants described their heart attack symptoms:

  • Pain, shortness of breath, fatigue. No gender differences
  • Right-side chest discomfort. 4.7 times more likely to be reported by men
  • Throat discomfort. 12 times more likely to be reported by women
  • Discomfort. 2.7 times more likely to be reported by men
  • Dull ache. 3.9 times more likely to be reported by men
  • Pressing on the chest. 7.3 times more likely to be reported by women
  • Vomiting. 3.9 times more likely to be reported by women
  • Indigestion. 3.7 times more likely to be reported by men

    Men were also five times more likely than women to recognize their symptoms as being related to their heart, say the researchers.

    Every Minute Counts During Heart Attack

    Participants didn't pick up the phone and call 911 right away when they noticed those symptoms. Both men and women delayed seeking medical help for hours.

    Men took about three hours, on average, before seeking help. Women waited even longer -- four hours, on average.

    Of course, that's extremely dangerous. It's vital to get help at the first sign of a heart attack. Don't wait, even if you're not sure what's going on; let doctors figure that out.

    Time can make the difference between life and death. Almost half of cardiac deaths in 1999 happened before emergency services and hospital treatment could be administered, says the CDC.

    "Educating both genders of the full constellation of symptoms of [heart attack] will help men and women recognize their symptoms sooner as cardiac related," say the researchers.

    SOURCES: Second International Conference on Women, Heart Disease, and Stroke, Orlando, Fla., Feb. 16-19, 2005. News release, American Heart Association. WebMD Medical Reference from Healthwise: "Understanding Heart Attack: Symptoms." American Heart Association, "Heart Attack." CDC, "Know the Signs and Symptoms of a Heart Attack."

    By Miranda Hitti, WebMD Medical News
    Reviewed by Brunilda Nazario, MD
    © 2005, WebMD Inc. All rights reserved