Heart attacks are more sexist than you think

Women suffer heart attacks in a different way from men and that may have disastrous consequences.

The image of a man clutching at his chest, struggling to catch his breath, his lips turning blue – the so-called “Hollywood heart attack” – may be true for males but the symptoms in females is altogether different, as Natalia Cotton explains in Women in Science magazine (via Bang!)

Although the dramatic “Hollywood heart attack” does occur, it is much more common in men than in women, who tend to experience more generalised symptoms, such as fatigue, vomiting and shortness of breath. These differences between the sexes in heart attack symptoms have long been noted but only recently has this area been explored empirically.

But still no one can really explain the differences.

One study from 2012 looked at the over one million American men and women who had suffered from heart attacks within a twelve year period. The authors found that 42% of men presented with chest pain compared to just 30.7% of women, and that this symptom was even less likely to occur in younger women. Why such variation exists between the sexes is not known. One prominent theory is that higher levels of oestrogen may change the behaviour of blood vessels in women.

There is evidence that the difference in symptoms is having tragic consequences. Heart disease is the second biggest killer of women in the UK after dementia, but women appear to be less likely to get checked out when experiencing a suspected heart attack than men. And even when they do, the prognosis is disappointing – again due to the difference in symptoms.

One study, which looked at 10,000 patients with heart attack symptoms at emergency departments in the US found that women aged below 55 were seven times more likely to be misdiagnosed and sent home than their male counterparts. This troubling pattern of misdiagnosis of women has disastrous consequences: women sent home during a cardiac event have double the chance of dying than those that remain in hospital. Even the treatment of heart attack patients appears to be subject to biases between sexes.