When it comes to heart attacks, it turns out the symptoms are the same for both men and women after all.

A study published in August in the Journal of the American Heart Association debunked the often cited idea that women experience different symptoms of a heart attack than men.

In fact, the study claims women are actually more likely to display the “typical heart attack symptoms” as compared to men. Researchers evaluated patient‐reported symptoms in nearly 2,000 people with suspected acute coronary syndrome who came into the emergency room of a hospital. Chest pain was the No. 1 complaint in 91% of men and 92% of women. Other typical symptoms of a heart attack were recorded as being more common in women than in men.

For years, the medical community warned women heart attacks can trigger “uncommon” symptoms such as heartburn or back pain rather than the more typical chest pain and pain radiating down the left arm.

The intent was to warn women not to dismiss such symptoms when, in fact, they could be signs of a life-threatening event. This study discounts that idea concluding men actually exhibited “uncommon” symptoms like heartburn, burning and stabbing pains and back pain more frequently while women reported pain radiating down their left arm along with chest pain.

Dr. J. Travis Wilson, a cardiologist with Allegheny Health Network based at Canonsburg Hospital, views the study results as the pendulum swinging back the other way.

“The classic teaching has always been that it’s perfectly fair game for women to present with atypical symptoms,” Wilson said. “But it doesn’t have to be the classic center of your chest crushing pain sort of story and it can be more atypical symptoms rather than the shortness of breath or palpitations or back pain or belly pain.”

Wilson said those are all symptoms doctors have been taught to be sensitive about with female patients.

“But what’s interesting, and what kind of motivated this study, is something that we struggle with,” he said, “is all of us coming together and agreeing on a universal definition which sounds like such a simple idea. But you’ll find in academia that everyone feels that their definition is the correct definition. And so for us to all get together on the same page is really kind of a big deal.”

Wilson said this study is important because it was conducted in Great Britain and the results could help doctors around the world come to an agreed upon definition of a heart attack.

“What I find interesting is, you know, women are usually right,” he said. “And what I mean by that is, those typical symptoms were more predictive of actually having a heart attack compared to men who presented with typical symptoms. So, I do think it was an interesting undertaking.”

Researchers said the clinical implications of this study are important because current international guidelines state women with myocardial infarction commonly present with atypical symptoms. That means women are at risk of under-diagnosis and under-treatment if correct symptoms are not recognized.

The study also found women more often reported palpitations as a symptom and that their pain radiated to the left arm, the back or to the neck or jaw. Women were more likely to report associated nausea, the study said.

Based on their findings, researchers recommend guidelines and educational material be updated to minimize the risk of under-diagnosis and treatment of women with myocardial infarction.

While previous educational campaigns urged women not to discount nontypical heart attack symptoms, they also did not say women didn’t have typical symptoms. That’s important because now the message to women is that they need to be aware of what’s happening with their bodies and to take any signs of a heart issue seriously.

“At the end of the day, I think the important thing is to simply, as providers, and also as patients, is to never dismiss yourself,” Wilson said. “You know, if you’re concerned, we’re concerned. And it’s a good reminder for us to always listen to our patients because you know your bodies better than anyone.”

Wilson said the point of the study is that doctors should never stereotype the way women should present symptoms associated with a heart attack because that could lead to a delay in treatment.

“I think the days of the saying that heart disease is only a men’s health issue is long by the wayside,” he said.

Columnist

Kristin Emery is a meteorologist at KDKA-TV in Pittsburgh, an O-R columnist, and writer for Total Health magazine and other publications. Kristin is a Washington native and a graduate of Washington High School and West Virginia University.

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