Why do women have to wait longer for help when having a heart attack?

Why do women have to wait longer for help when having a heart attack?
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According to a new study published in the European Heart Journal: Acute Cardiovascular Care, women should call an ambulance immediately if they experience heart attack symptoms. This recommendation is being made after study findings showed that women have to wait longer than men to get help when having  a heart attack. 

Ischaemic heart disease is the leading cause of death in both men and women. Even though there is a perception that heart attacks are primarily a "man's problem", the fact is that they are just as common among women. In fact, women are often much older (about 8 to 10 years) than men when they have a heart attack and they also have different symptoms compared to men. Women could benefit from faster treatment as much as men; unfortunately that does not happen. 

4360 patients (957 women and 3393 men) with acute ST-segment elevation myocardial infarction (STEMI) treated at Triemli Hospital between 2000 and 2016 were included in the analysis. The primary outcomes of interest included changes in patient delay (i.e time from symptom onset to contact with a healthcare provider or service) and system delay (time from onset until reopening of the blood vessel). In-hospital mortality was the secondary outcome of interest.

The analysis showed that during the 16-year period, both men and women had equal reductions in system delays. Both men and women received a stent quickly after contacting the medical services compared to in the past. However, the patient delay reductions decreased in men but did not change in women. Women had to wait approximately 37 minutes longer compared to men before contacting medical services. Persistent chest pain was also associated with shorter patient delays in men compared to women. This indicates that women are less likely to attribute their symptoms to a heart attack compared to men. 

In-hospital mortality was also higher in women (5.9%) compared to men (4.5%). Dr. Matthias Meyer, a cardiologist at Triemli Hospital, Zurich, Switzerland and the lead author of this study explains that in-hospital mortality is more driven by acute complications of a heart attack rather than delays but delays do play a role in predicting long-term mortality. 

Dr. Meyer also points out that delay in treating women might be because of the myth that heart attacks usually occur in men. Also, since the best known symptoms of a heart attack are pain in the chest and left arm, women tend to be misdiagnosed because their heart attack symptoms are different from men. 

“Women and men have a similar amount of pain during a heart attack, but the location may be different,” Dr. Meyer said. “People with pain in the chest and left arm are more likely to think it’s a heart attack, and these are usual symptoms for men. Women often have back, shoulder, or stomach pain.”

When a patient is having a heart attack, fast treatment is critical to survival. If the attack is due to acute blockage of an artery that supplies blood to the heart, it is imperative that the vessel is reopened by inserting a stent. This results in faster restoration of blood flow, more salvaged heart muscle and less dead tissue. All this translates into a lower risk of death. Over the last 10 to 15 years, significant effort has been made to employ multiple strategies within heart attack treatment networks so that patents are treated faster and time delay between symptoms and treatment is reduced. However, delays in women continue to persist compared to men. 

Dr. Meyer emphasised that when you have a heart attack, every minute counts. Patients, especially women, should look out for symptoms such as pain in the chest, throat, neck, back, stomach or shoulders and if such pain lasts for more than 15 minutes, they should take it seriously. If these symptoms are accompanied by nausea, cold sweat, weakness, shortness of breath or fear, women should contact a healthcare provider so that they can be monitored and treated quickly. 

Image Credit: iStock 

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Published on : Wed, 19 Dec 2018

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Stent, heart attack, ischaemic heart disease According to a new study published in the European Heart Journal: Acute Cardiovascular Care, women having a heart attack have to wait longer than men to get help.

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