Heart attacks in women are still being missed

Reported by Susan Aldridge, PhD, medical journalist

Women are less likely to be correctly diagnosed with a heart attack, even though new guidance is now available.
Until menopause, women are less likely to suffer heart attacks than men. This may have led to the belief that heart disease in women is rare. Research shows that women are less likely to be diagnosed and more likely to have a poor outcome.

Researchers at Hull Royal Infirmary, England, have looked at a group of patients to see how the women fared. They gathered samples of a substance called cardiac troponin, whose rise is now thought to be strongly indicative of heart attack. The samples came from almost 5,000 patients - around half of them male of average age 66. The average age of the women was 74.

Among the 561 heart attacks recorded, over 90 per cent were associated with increased levels of troponin. In all, 1,304 had increased troponin, which means many were still not diagnosed as having a heart attack, even though this is a hallmark sign. Women were less likely to be diagnosed with a heart attack than men if they had raised troponin. The researchers point out that the new guidance says even slight increases in troponin may mean a heart attack. It looks, from this study, as if many heart attacks may be being missed - especially among women. Maybe it is time to raise awareness of the new diagnostic criteria for heart attack?

Source
Heart January 2005 Volume 91 pages 237-238