Introduction:
Myocardial infarction patients report higher prevalence of atypical symptoms in women, contributing to a less probability of a correct diagnosis. Studies exploring only the STEMI group where a prompt diagnosis is mandatory is lacking. We hypothesised that chest pain is equally common in women and men in a STEMI population. We further hypothesised that women have more associated symptoms than men in a STEMI population and thus a longer delay time.
Methods:
SymTime is a multicentre observational study where patients with a diagnosis of STEMI, admitted to CCUs where included. Within 24 h from admission they filled in a validated Swedish questionnaire, developed to measure how patients with MI describe their symptoms and actions in the pre-hospital phase.
Results:
126 women and 406 men were included, mean age 70 and 64 (SD11) years respectively. After age adjustment, men had 5 times higher odds of having chest pain. Women had more symptoms in other typical locations. (Table) Only general feelings of illness (25 vs 13%, p = .001), fearfulness (31 vs 17 %, p.= 001) and nausea (49 vs 29 %, p < .001) were more common in women. Women had longer delay times from symptom onset to first medical contact, median time 1:30 hours: minutes vs 1:05 in men (p = 0.03).
Conclusion:
Women had significantly less chest pain, one reason for longer delay times in women. The prevalence of other typical MI symptoms such as pain in the chin/teeth, throat, shoulders, arms or back was higher in women. These findings should be communicated to the health care system as well as the community in order to get a prompt and correct diagnosis of STEMI in both genders.
Table.
Main symptom(s) in women and men with STEMI
Early, Subacute Coronary Stent Thrombosis: A Complication of COVID-19 Infection
