Young women less likely to recognize chest pain symptoms as heart related

   According to research out of the Yale University School of Public Health, New Haven, Connecticut, young adults are less likely to attribute chest pain to heart-related problems.

   The VIRGO Study enrolled 2990 myocardial infarction (MI) patients aged 18-55, from 104 US hospitals from from 2008 through 2012 using a 2:1 female/male enrollment design. Information on MI symptoms, perceived cause of symptoms, and interactions with the healthcare system for symptoms was collected from patient interviews during the hospitalization.

   Ninety percent of men and 87% of women presented with chest pain, pressure, tightness, or discomfort; women presented with more additional symptoms, such as radiating pain, indigestion/nausea, shortness of breath, sweating, weakness/fatigue, palpitation, and confusion.

   Among those presenting without chest pain, there were no differences in symptoms by sex, with only 9% presenting with no classical symptoms. Almost 60% of participants attributed symptoms to non-cardiac conditions; women commonly cited indigestion or stress/anxiety, whereas men reported indigestion or muscle pain. More women reported waiting more than one day to seek care than men (55% vs 49%, P <0.05). Persistent symptoms was the most common care seeking trigger for men and women, but women were less likely to report concern about heart disease as a trigger for seeking care (41% vs 49%, P <0.001).     Almost one in three women and one in five men visited their doctor for symptoms before their hospitalization; 45% of women and 62% of men (P <0.001) reported being told their symptoms might be related to a heart problem.