Heart attacks are not necessarily accompanied by chest pain especially in women under the age of 55, according to a new study, and, in such cases, doctors may not be as quick to order tests to diagnose heart problems. That could delay treatment and increase the risk of death.
The McGill University study looked at more than 1,000 young patients who were hospitalized for heart attacks and angina. “To our surprise we found that most men and women do present with chest pain when they sustain a heart attack, but we still found that there were one in five women in that younger age group…who did not have chest pain when they presented,” said Dr. Louise Pilote, director of internal medicine at the McGill University Health Centre and senior author of the study.
Other symptoms, heart attack just as severe
These patients may have displayed other symptoms such as sudden weakness, shortness of breath, feeling hot or cold, and pain in the left arm or shoulder and these symptoms may have been less severe. But that does not mean their illness was less severe. The study indicated the severity of the heart attack was the same whether or not there had been prior chest pain.
Many of these heart patients with no chest pain symptoms had high risk factors for heart attack including smoking, high blood pressure, high cholesterol, diabetes, obesity. “This is in our Canadian population,” said Pilote. “And we are seeing the consequence of all that.”
Young women may not get quick blood test
An older man who goes to a hospital emergency room with chest pain would quickly get an electrocardiogram and a blood test which would show whether he has biomarkers indicating a heart attack, says Pilote. But doctors would be less likely to order the tests for a younger woman with no chest pain.
“So even if it’s a young woman who presents to the emergency room with symptoms that are not chest pain but they have a very high burden of coronary disease risk factors I think we should be evaluating the use of those biomarkers (by ordering a blood test) earlier on in the diagnostic process.”
Prevention is best, says doctor
Prevention is best though, says Pilote. “Young people should be really aware that the traditional risk factors– smoking, obesity that leads to diabetes and hypertension, and high cholesterol–if controlled will prevent you from having all these issues.”
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