Women having a heart attack wait longer than men to get help

What is it about?

In heart attacks caused by acute blockage of an artery supplying blood to the heart, rapid reopening of the vessel by inserting a stent is critical. Faster restoration of blood flow translates into more salvaged heart muscle and less dead tissue, less subsequent heart failure, and a lower risk of death. During the last 10–15 years strategies such as treatment networks have been employed to reduce the time delay between symptoms and treatment. This study investigated whether delays have reduced in women and men. The study was a retrospective analysis of all 4,360 patients (967 women and 3,393 men) with acute ST-segment elevation myocardial infarction (STEMI) treated at Triemli Hospital, the second largest percutaneous coronary intervention (PCI) centre in Switzerland, between 2000 and 2016. The primary outcomes of interest were changes in patient delay (the time from symptom onset to contact with a hospital, emergency medical service, or general practitioner), and system delay (the subsequent time before stent implantation). The secondary outcome of interest was hospital mortality. During the 16-year period, women and men had equal reductions in system delays, indicating no gender difference in the timely delivery of care by health professionals, with both men and women receiving treatment more quickly after contacting the medical services than they did in the past. However, patient delay decreased slightly in men over the 16-year period but did not change in women. Women now wait approximately 37 minutes longer than men before contacting medical services. Clinical signs of persistent chest discomfort were associated with shorter patient delays in men but not women. Thus, women having a heart attack seem to be less likely than men to attribute their symptoms to a condition that requires urgent treatment.

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Why is it important?

Ischaemic heart disease is the leading cause of death in women and men. There is a misconception that heart attacks are a ‘man’s problem’ but they are just as common in women. On average, women are about 8–10 years older than men when they have a heart attack and they tend to experience different symptoms. People with pain in the chest and left arm are more likely to think it’s a heart attack, and these are usual symptoms for men. However, women often have back, neck, shoulder, or stomach pain. This may be the reasons why women wait longer than men to get professional help. However, women benefit equally from fast treatment and should be educated to call an ambulance immediately if they have heart attack symptoms.