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Women more likely than men to dismiss chest pain and delay seeking medical help for heart symptoms

When heart symptoms strike, men and women go through similar stages of pain but women are more likely to delay seeking care and can put their health at risk, according to a study presented at the Canadian Cardiovascular Congress.

“The main danger is that when someone comes to the hospital with a more severe or advanced stage of heart disease, there are simply fewer treatment options available,” says Dr. Catherine Kreatsoulas, lead author of the study and a Fulbright Scholar and Heart and Stroke Foundation Research Fellow at the Harvard School of Public Health.

Dr. Kreatsoulas, an epidemiologist, says we don’t know enough about how people perceive their heart symptoms and at what stage they are prompted to seek medical care. Her study included patients with suspected coronary artery disease, just prior to undergoing their first coronary angiogram test.

The study was conducted in two parts. In the first part, researchers interviewed cardiac patients about their experience of angina and their decision to seek medical care. A new group of patients was enrolled into the second phase of the study, which quantified by gender the reasons why patients sought care.

Angina is the pain that occurs when your heart doesn’t get as much blood and oxygen as it needs because of a blockage of one or more of the heart’s arteries. This pain is often described as a pressure, tightness or burning feeling. It is a warning signal that you are at increased risk of a heart attack, cardiac arrest or sudden cardiac death.

The researchers developed the term “symptomatic tipping point” to capture the transitional period someone goes through between experiencing cardiac symptoms and getting medical attention. They identified six transitional stages, common to both men and women. Men, she notes, responded to these symptoms faster.

The six stages, in chronological order, include:

  • a period of uncertainty (patient attributes their symptoms to another health condition),
  • denial or dismissal of symptom,
  • seeking assistance/second opinion of someone such as a friend or family member,
  • recognition of severity of symptoms with feelings of defeat,
  • seeking medical attention, then
  • acceptance.

Women stayed in the denial period longer than men. While men would consult with a friend or loved one more readily about the symptoms, “women would wait for others to tell them they looked horrible,” says Dr. Kreatsoulas. “Women displayed more of an optimistic bias, feeling that the symptoms would pass and get better on their own.”