Gender, Age Influence Symptoms of Heart Attack

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A heart attack, or myocardial infarction (MI), occurs when a portion of the heart muscle becomes oxygen-starved due to clogged blood vessels. This can damage or kill the affected portion of muscle. Depending upon the amount of muscle involved, heart attacks range from mild to life-threatening. The best predictor of whether a heart attack sufferer will survive an acute MI is their ability to identify that a heart attack is taking place and get medical help.

In the media, heart attacks are portrayed as occurring with sudden-onset, crushing chest pain. However, studies show that many heart attacks present without any chest discomfort [1]. Women are particularly likely to experience heart attacks without chest pain, which physicians have speculated is behind the higher mortality of female heart attack sufferers. However, because women tend to be older than their male counterparts at the time of an MI, it’s possible that age, rather than gender, is behind the difference in symptoms. A new study in the Journal of the American Medical Association examined the relationships among gender, age, and heart attack symptoms [2].

The researchers found that, as expected, significantly more female heart attack-sufferers presented without chest pain as compared to male heart attack-sufferers (42% vs. 30.7%). They also found, however, that the likelihood of experiencing chest pain as a symptom of MI decreases with increasing age in both genders. While women of any age are less likely than men of the same age to experience chest pain with a heart attack, the effect is most pronounced in younger women. Women under 45 who have a heart attack are 30% more likely than men of the same age to present without chest discomfort. Women older than 75 who have a heart attack, on the other hand, are only 3% more likely than men of the same age to present without chest discomfort.

The “classic” symptoms of a heart attack, aside from chest pain or discomfort, include pain in the arms, neck or jaw, and shortness of breath. Additional, and less well-recognized, symptoms include an unexplained feeling of anxiety, dizziness, sweating, nausea, and stomach pains. Some heart attacks present like a case of the flu.

The best course of action in the case of a suspected heart attack is to call 911 immediately. It’s also a good idea to have regular medical checkups, so that a healthcare practitioner can evaluate risk factors for heart disease.

References

1. Canto et al. Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA. 2000 Jun 28;283(24):3223-9.
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2. Canto et al. Association of Age and Sex With Myocardial Infarction Symptom Presentation and In-Hospital Mortality. JAMA. 2012 Feb 22;307(8):813-22.
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