MONDAY, May 10, 2021 (HealthDay News) – When young women land in the emergency room with chest pain, they wait longer and receive less treatment than their male counterparts, according to a preliminary study.
Using a federal survey of US hospitals, researchers found that younger women with chest pain were treated less urgently than men their age. This included a lower likelihood of receiving standard tests to diagnose a heart attack.
Chest pain can have a variety of causes, including minor issues such as muscle fatigue and acid reflux.
But it’s also the most common symptom of heart attacks in women and men, said study co-author Dr Harmony Reynolds, a cardiologist at NYU Langone Health in New York City.
It is not known why young women were treated differently for their chest pain. But implicit biases on the part of some medical professionals could be at work, Reynolds said. The old stereotype that heart attack is a “human disease” still persists.
The study is far from the first to uncover a gender gap in the treatment of heart attacks. Others have shown that women receive fewer drugs recommended for post-heart attack care and have a higher risk of dying a few years after a heart attack.
The new findings add to the bigger picture, in part, by focusing on young adults, said lead researcher Dr. Darcy Banco, internal medicine resident at NYU Langone.
Although heart attacks are more common in older people, they also strike at younger ages.
In fact, Banco said, recent years have seen some “disturbing trends” among young Americans – especially women.
A study published in February found that since 2010, deaths from heart disease have been on the rise among American women under the age of 65. The researchers pointed out that the “worsening epidemics” of obesity and type 2 diabetes were likely the culprits.
And over the past two decades, about a third of women hospitalized for a heart attack were under 55, according to the American College of Cardiology (ACC).
The current study focused on emergency care, using data collected from US hospitals between 2014 and 2018.
He found that women were just as likely as men to arrive by ambulance, but their cases were less often deemed “emerging.” On average, women waited about 11 minutes longer to receive care.
It might seem like a small difference, but minutes count in treating a heart attack, Banco said.
According to medical guidelines, all patients arriving at the emergency room with possible symptoms of a heart attack should receive an electrocardiogram (ECG) within 10 minutes. EKGs record the electrical activity of the heart and are the standard initial test to diagnose a heart attack.
Still, the young women in this study aged 18 to 55 were less likely to receive an EKG: around 74% did, compared to 79% of men. Women were also seen less often by a consultant, such as a cardiologist (8.5% versus 12%), or placed under cardiac monitoring (25% versus 30%).
Banco will present the results on Saturday at the ACC annual meeting, which will be held online. Studies reported at meetings are generally considered preliminary until published in a peer-reviewed journal.
Dr. Ileana Piña, a volunteer medical expert with the American Heart Association, was not surprised by the results.
“The perception that women don’t have heart disease still exists,” said Piña, clinical professor of medicine at Central Michigan University.
She said examples abound where women’s symptoms are seen as stress or indigestion. This is despite the fact that heart disease is the No.1 killer of both men and women, Piña said.
What should women do?
First, it’s important to know the symptoms of the heart attack and act on it, the three doctors said.
Be aware, Reynolds said, that heart attacks often cause discomfort – rather than crushing pain – in the chest. And women are more likely than men to experience certain other symptoms, including shortness of breath, nausea, and pain that travels to the jaw or upper back.
When these symptoms appear, studies show that women often delay calling 911.
“We’re going to call everyone except ourselves,” Piña said.
But as the current study shows, even when women with chest pain call for an ambulance, their care may not be the same as that of men.
Again, all three doctors had similar advice: ask questions. Tell emergency providers that you are worried about having a heart attack and want to know what tests have been done.
Piña recommended asking to see the cardiologist on duty.
“I think we have to be a little demanding,” she said.
The American Heart Association has more information on women and heart disease.
SOURCES: Darcy Banco, MD, MPH, internal medicine resident, NYU Langone Health, New York City; Harmony Reynolds, MD, associate professor, medicine, NYU Grossman School of Medicine, New York City; Ileana Piña, MD, MPH, clinical professor, medicine, Central Michigan University, Mount Pleasant, Michigan, and volunteer medical expert, American Heart Association, Dallas; presentation, online meeting, American College of Cardiology, May 15, 2021
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