Heart attack diagnosis less likely in women

ven with new, more objective criteria, women are still less likely than men to have their heart condition accurately diagnosed as a heart attack, researchers report.

By under-reporting the labeling of heart attack in women "we may be perpetuating the myth that it is mainly men that have heart attacks," co-author Dr. Eric S. Kilpatrick told AMN Health.

Guidelines now state that increases in two enzymes released by damaged heart tissue - cardiac troponin T (cTnT) or cardiac troponin I (cTnI) - above the 99th percentile of "normal" is sufficient to diagnose a heart attack, Kilpatrick and a colleague, Dr. S. A. Madrid Willingham note in a report in the journal Heart. The two physicians are based at Hull Royal Infirmary in the UK.

They evaluated 6172 samples of cTnT from 2505 men and 2323 women admitted to the hospital with chest pain in 2002.

A total of 1304 hospital admissions (713 men and 591 women) were associated with elevated cTnT levels. However, only 521 or 40 percent of cases were discharged with a diagnosis of heart attack - 46 percent of them were men and just 33 percent were women.

It appears that doctors are still using older definitions of what constitutes a heart attack because they "are still indoctrinated into thinking that having a heart attack is largely a male preserve," Kilpatrick told AMN Health.

One danger in this approach, he added, is that by not recognizing their risk of heart attack, women may not attend to their cardiovascular risk factors as they might otherwise.

SOURCE: Heart, February 2005.