Chest pain no more an indicator of heart attacks in women aged under 55

Although chest pain is recognised as a symptom of heart troubles, a new study has found that one out of five women aged 55 years or less having a heart attack do not experience this symptom.

The study led by the Research Institute of the McGill University Health Centre has implications for emergency room healthcare professionals and for at-risk individuals, as seconds matter when it comes to the accurate diagnosis and treatment of heart attack.

Senior author of the study, Dr Louise Pilote, said that chest pain, age and gender are no longer the definers of a heart attack.

“Our study demonstrates that young people and women who come into the emergency without chest pain, but other telltale ACS symptoms such as weakness, shortness of breath and rapid heartbeats, are in crisis. We need to be able to recognize this and adapt to new standard assessments in previously unrecognized groups such as young women,” Pilot said.

First author Dr Nadia Khan said that women less than 55 years old are more likely to have their ACS misdiagnosed in the ER than men, and they have higher risk of death.

Pilote and Khan and colleagues evaluated more than 1,000 young patients who were hospitalised for ACS. Their findings showed that women were less likely to experience chest pain compared with men and that the absence of this pain did not correlate with less severe heart attacks.

Patients without chest pain had fewer symptoms overall but their ACS was not less severe. The diagnosis of ACS, therefore, depended on detailed cardiological assessments.

The study is published in JAMA Internal Medicine.