Women Not Getting Prompt Emergency Treatment

In medical emergencies, most people are conditioned to pick up the phone and dial 9-1-1. But if you are a woman having a heart attack, dialing that number may not be your best bet. A new report published in Circulation: Cardiovascular Quality and Outcomes reveals that women experiencing cardiac symptoms were much less likely than men to receive prompt medical care after calling 9-1-1.

If a woman is having cardiac symptoms: “It turns out that (she is) more likely to be delayed from the time of symptom onset, through transport and all the way to definitive care,” explains Thomas W. Concannon, Ph.D., the study’s lead author and assistant professor of medicine at the Institute for Clinical Research and Health Policy Studies at Tufts Medical Center in Boston, Mass.

It has long been established that women experience different cardiac symptoms than men, especially during an acute attack. Doctors often diagnose a heart attack by evaluating a patient’s symptoms. However, women are more likely to experience nausea, vomiting, upper-back pain, shortness of breath, dizziness and indigestion which are not considered to be the hallmark signs of a heart attack.

And while the study did not uncover the reasons why women were more likely to receive delayed treatment, it confirms the notion that heart-related symptoms may not be recognized as easily in women. According to Concannon, “Delays could be happening because the patient and the clinician are slower to recognize symptoms as cardiac-related (in women).”

An acute heart attack occurs when a blocked vessel restricts blood flow to an area of the heart muscle. The lack of blood flow means this area of the heart is deprived of oxygen. The longer a heart attack victim goes without receiving medical treatment, the longer the heart muscle goes without receiving oxygen. This oxygen deprivation causes significant, and sometimes irreversible, damage to the heart muscle. A phrase used by critical care professionals to underscore the importance of timely treatment is: “time lost equals muscle lost.”

According to Concannon, “Delays of 15 minutes have been shown to contribute to a significantly larger area of damage to heart muscle in patients with heart attack. While our study included patients with any cardiac related symptom, we studied 15 minute delays because of their potential for harm in patients with heart attack.”

Because delayed treatment has such serious consequences, women need to be aware of their own risk for heart disease. “In an emergency situation, symptoms such as shortness of breath and chest tightness are often viewed as psychogenic, rather than of cardiac origin,” said Jennifer H. Mieres, M.D., spokesperson for the American Heart Association’s Go Red For Women campaign, in a news release issued by the AHA. “Women must be actively engaged in their health, listen to their bodies and insist on a thorough evaluation of critical heart health factors.”

Knowing the risk factors for cardiovascular disease is vital for women and men. They include:

A family history of heart disease
Increasing age
High blood pressure
High cholesterol
Physical inactivity
Tobacco smoke

Exercising regularly, eating well and having annual screenings for blood pressure and cholesterol can lower your risk of heart disease. Being proactive in your own health care can also play a large role in the proper diagnosis and prompt treatment of heart and other major diseases.

SOURCE: Circulation: Cardiovascular Quality and Outcomes, January 13, 2009.

Source: Society for Women’s Health Research (SWHR)

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