What's so different about heart attacks in women?

Women presenting to the hospital with heart attacks have greater variation in the clustering of symptoms than men, and women tend to have more symptoms per patient than men. This can present a challenge to doctors diagnosing heart attacks in women.  

John Brush Jr, MD, Sentara Cardiology Specialists, says his findings, published in the journal Circulation: Cardiovascular Quality and Outcomes, might explain why heart attacks are missed more often in women than in men and should encourage physicians to expand their thinking when it comes to diagnosing female patients. Brush referred to this as a 'think different' kind of study. "It's a new idea about how to look at the diagnosis of acute myocardial infarction," he says.

Published online February 17, 2020, ahead of print in Circulation: Cardiovascular Quality and Outcomes, the new study: Sex Differences in Symptom Phenotypes Among Patients with Acute Myocardial Infarction is an analysis of the Variation in Recovery: Role of Gender on Outcomes of Young Acute MI Patients (VIRGO) multicenter registry.

Brush states that women have more phenotypes, which are the composite of an organism's observable characteristics or traits. An abundance of phenotypes in women could create confusion for a doctor trying to reach a diagnosis. If a woman is having an acute MI, but her phenotype is not what a doctor expects, then a missed diagnosis is more likely. Brush emphasized teaching physicians to be more expansive in their thinking about acute MI symptoms and how those symptoms combine in an individual patient.