Women Face Delays in Heart Attack Care Compared to Men

Among young and middle-aged adults, men tend to receive faster hospital care than women for heart attacks and chest pains, a new study finds.

Anxiety appeared to be a key factor -- women who appeared anxious upon admittance to the hospital tended to have delays in crucial care, the study authors found.


"Patients with anxiety who present to the emergency department with noncardiac chest pain tend to be women, and the prevalence of [heart attack or chest pains] is lower among young women than among young men," the Canadian researchers said. "These findings suggest that [emergency-room staff] might initially dismiss a cardiac event among young women with anxiety."

One heart expert wasn't surprised by the findings.

"It has been shown in multiple trials that there are gender differences in the treatment of heart disease between men and women entering a hospital," said Dr. Suzanne Steinbaum, director of women and heart disease at Lenox Hill Hospital in New York City.

"In younger adults, ages 18 to 55, this reality has also shown to be true," she said. "When women enter a hospital, it is critical that this bias is eradicated."

In the study, researchers looked at more than 1,100 adults aged 55 or younger treated for heart attack or chest pains -- also called angina -- at 24 hospitals in Canada, one in the United States and one in Switzerland. The median ages of the patients were 50 for women and 49 for men.

After arriving at the hospital, men underwent electrocardiograms (ECGs) within 15 minutes and clot-dissolving therapy within 21 minutes, compared with 28 minutes and 36 minutes, respectively, for women, the researchers said in the March 17 issue of the Canadian Medical Association Journal.

"Anxiety was associated with failure to meet the 10-minute benchmark for ECG in women but not in men," said the researchers, led by Dr. Louise Pilote, a professor of medicine at McGill University in Montreal.

Digging deeper, the researchers found that patients with multiple heart attack risk factors and those with heart attack symptoms that were considered outside the norm also faced delays in care.

Steinbaum pointed out the incongruity of some of these findings.

"When analyzed, the women patients were sicker and were more likely to have diabetes, high blood pressure and a family history of heart disease," she said. "With these multiple risk factors for heart disease, the likelihood of symptoms being heart-related are higher -- yet they were not as expeditiously treated for a heart attack."

"This delay in treatment is critical, especially in the setting of a heart attack, as death rates in patients who have multiple health problems is higher," Steinbaum said.

Another heart specialist agreed.

"Since women often present with nontypical symptoms when having a heart attack, it is very important that physicians look at younger women, too, to make sure the symptoms they are having do not represent a developing heart attack," said Dr. Lawrence Phillips, an assistant professor in the department of medicine at NYU Langone Medical Center in New York City.

"One of the most important take-home points from this study is the need to have an electrocardiogram early," Phillips said. "An ECG is able to, in many cases, diagnose a heart attack as it occurs. By improving the rapidity of this test, we can start needed therapy earlier and, in doing so, save lives."

SOURCES: Suzanne Steinbaum, M.D, director, women and heart disease, Lenox Hill Hospital, New York City; Lawrence Phillips, M.D, assistant professor, department of medicine, Leon H. Charney Division of Cardiology, NYU Langone Medical Center, New York City; Canadian Medical Association Journal, news release, March 17, 2014