New findings on heart attack symptoms

Issue: BCMJ, vol. 55 , No. 9 , November 2013 , Pages 413 News

New study findings by researchers with Providence Health Care warn that relying on traditional symptoms to recognize heart attacks in women and young people can lead to mis-diagnoses. 

Researchers evaluated sex and age differences in acute coronary syndrome and discovered that one out of five women aged 55 years or younger do not experience chest pain when having a heart attack. The study, a collaboration between Providence Health Care, the University of British Columbia, and the McGill University Health Centre, is published in the September issue of JAMA Internal Medicine.

While chest pain is the symptom most commonly associated with heart attacks and angina, the study shows that it is not always present. Other symptoms to look for include weakness, feeling hot, shortness of breath, cold sweats, and pain in the left arm or shoulder. These were the most common symptoms reported by women and men who did not experience chest pain.

The study evaluated more than 1000 young patients age 55 or less across Canada who were hospitalized for acute coronary syndrome. Findings show that one in five women did not experience chest pain with their heart attacks or angina, and women were less likely to experience chest pain compared with men. 

Heart attacks without chest pain were no less severe than heart attacks with chest pain present. Patients without chest pain had fewer symptoms overall but their acute coronary syndrome was not less severe, and the diagnosis of acute coronary syndrome therefore depended on detailed cardiological assessments.

The study can be viewed at

. New findings on heart attack symptoms. BCMJ, Vol. 55, No. 9, November, 2013, Page(s) 413 - News.

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