Sex differences in symptom presentation in acute myocardial infarction: a systematic review and meta-analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of observational studies
PubMed 22000678 · doi:10.1016/j.hrtlng.2011.05.001
What was done
Authors performed a systematic review and meta-analysis of English-language studies published between 1990 and 2009 to determine whether women and men with acute myocardial infarction (AMI) present differently, specifically evaluating the likelihood of presenting with chest pain and other symptoms.
What was found
Women with AMI were significantly less likely than men to present with chest pain (OR 0.63, 95% CI 0.59 to 0.68; RR 0.93, 95% CI 0.91 to 0.95). In addition, women were significantly more likely than men to present with fatigue, neck pain, syncope, nausea, right arm pain, dizziness, and jaw pain, although the abstract reports no specific numerical effect sizes or confidence intervals for these individual non-chest pain symptoms.
Why it matters
While chest pain remains a key presentation for both sexes, recognizing that women have lower relative rates of chest pain and higher frequencies of other symptoms can help prevent delayed diagnosis and under-recognition of AMI in female patients.
Limits
The abstract does not state the number of included studies, total sample size, or degree of between-study heterogeneity. Data are limited to observational studies published up to 2009 in English, and exact statistical estimates for secondary symptoms are omitted.
Cited by
- context During heart attacks, chest and arm pain are less common in women than in men, while shortness of breath is more common in women.