Title

Time to standardize and broaden the criteria of acute coronary syndrome symptom presentations in women

UMMS Affiliation

Meyers Primary Care Institute; Department of Quantitative Health Sciences

Date

7-1-2014

Document Type

Article

Medical Subject Headings

*Acute Coronary Syndrome; Diagnostic Imaging; *Disease Management; Female; Humans; Morbidity; Risk Assessment; Risk Factors; Sex Factors; Time Factors; World Health

Disciplines

Cardiology | Cardiovascular Diseases | Diagnosis | Women's Health

Abstract

Early recognition of the signs and symptoms of acute coronary syndromes (ACS) is essential to improving patient management and associated outcomes. It is widely reported that women might have a different ACS symptom presentation than men. Multiple review articles have examined sex differences in symptom presentation of ACS and these studies have yielded inconclusive results and/or inconsistent recommendations. This is largely because these studies have included diverse study populations, different methods of assessing the chief complaint and associated coronary symptoms, relatively small sample sizes of women and men, and lack of adequate adjustment for age or other potentially confounding differences between the sexes. There is a substantial overlap of ACS symptoms that are not mutually exclusive according to sex, and are generally found in women and men. However, there are apparent differences in the frequency and distribution of ACS symptoms among women and men. Women, on average, are also more likely to have a greater number of ACS-related symptoms contributing to the perception that women have more atypical symptoms than men. In this review, we address issues surrounding whether women should have a different ACS symptom presentation message than men, and provide general recommendations from a public policy perspective. In the future, our goal should be to standardize ACS symptom presentation and to elucidate the full range of ACS and myocardial infarction symptoms considering the substantial overlap of symptoms among women and men rather than use conventional terms such as "typical" and "atypical" angina. All rights reserved.

Rights and Permissions

Citation: Can J Cardiol. 2014 Jul;30(7):721-8. doi: 10.1016/j.cjca.2013.10.015. Link to article on publisher's site

Related Resources

Link to Article in PubMed

PubMed ID

24530216