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Myocardial infarction: women wait longer than men

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Female victims of myocardial infarction may wait longer than men before being treated, which can have a negative impact on their prognosis, warn two experts in Montreal.

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Women experience the same symptoms as men during a heart attack, says Dr. Jessica Forcillo, who is a cardiac surgeon at CHUM, but they describe them differently than men, which can send doctors on the first line down a wrong path.

Men who go to the emergency room (with a heart attack), we call this presentation in Hollywood: a point on the chest, coming from the arm or jaw. Women, we think it’s the same kind of symptoms, but it’s the way it’s expressed differently, which can be difficult for the incoming physician to definitely make the link to the infarction.

A quote from Jessica Forcillo, cardiac surgeon at CHUM

In addition, some of the symptoms (nausea, hot redness, fatigue) may be confusinghe added. So the women came, come, come, they show up, they had no diagnosis, and finally they were diagnosed with something, and then they went to surgery.lament of Dr. Forcillo.

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The bikini approach

Her colleague, cardiologist Christine Pacheco, recalled that we had long since adopted the bikini approach, which is the approach of primarily looking at a woman’s healthy reproductive system and then really kind of ignoring others.

I had a patient with chest pain, discomfort, who went to his GP who said, “Oh, maybe it’s heartburn, here’s a bottle of Pepto -Bismol, go home”. Then finally two weeks later I saw him in the ER because symptoms were getting worse and worse.said Dr. Pacheco, who is the only medical specialist in Quebec to hold a sub-specialization in women’s health.

Such delays in adequate care often result in sequelae that can be avoided, he added. And this is not a single story, unfortunately.

On initial evaluation of this patient, Dr. Pacheco, the possibility of heart disease was excluded. due to the medical profession, historically, heart disease in women has been relatively noticeable.

Necessary tests may also occur later. In a recent study in America, for example, it was found that electrocardiograms and blood tests that make it possible to diagnose a heart attack occur later in women than in men, delaying adequate treatment. for pain.

More than just breast cancer

Doctors Pacheco and Forcillo are two of the founders of Cardio F, a CHUM clinic that specializes in the prevention, diagnosis and treatment of cardiovascular disease in women.

But front-line doctors who don’t know that the patient in front of them is having a rapid heart attack aren’t the only ones to blame, two specialists said: Women themselves may take longer than men to understand if what happens to them because, let’s remember, cardiovascular disease is traditionally the male passion of the popular imagination.

Less than a quarter of women discussed their cardiovascular risk with their doctor. However, one in three Canadian women will suffer from cardiovascular disease for the rest of her life, and cardiovascular disease will kill five times more women than breast cancer. Canadian data, for example, shows that women aged 18 to 65 are more likely to die than men within a year after their heart attack.

Other studies show that the mortality rate in young women is higher than in men, and the symptoms they describe seem different. For example, they may feel less severe pain than older women. The causes of heart attacks can also be different for them.

COVID and stress cardiomyopathy

In young women, one of these reasons is related to the proliferation of family and work -related roles, Drs. Forcillo. We also saw this increase during COVID with stress cardiomyopathies; we call it ‘Broken Heart Syndrome‘, which is more prevalent among young women. It is an infarction mechanism that is not a blockage in the arteries, but is associated with stress that more specifically manifests itself in younger women.

And while known risk factors such as obesity, smoking, and physical inactivity can affect members of the same sex, others more specifically women should hold the attention of physicians.

High blood pressure, diabetes during pregnancy, fertility treatments, depression, early menstruation…, Dr. concludes. Forcillo. There are many other factors like that that can be attributed and are still unknown in the medical profession.

Source: Radio-Canada

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