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Women’s chest pain may get less emergency attention than men’s

Heart disease is the leading cause of death in both men and women…and it is unfortunately becoming more common in younger adults of both sexes. In fact, about one-third of women hospitalized for a heart attack over the past two decades were under the age of 55.

However, when women under 55 come to the hospital with chest pain, they wait longer to be seen, are less likely to receive basic heart attack screening tests, and are identified as needing immediate treatment less often than men, a recent NYU Langone Health study found.

The study was based on data collected for the National Hospital Ambulatory Medical Care Survey between 2014 and 2018. The NYU researchers expanded its results to encompass about 29 million emergency department visits for chest pain made by American adults 18-55 during that period, of which 57% were by women.

Although similar numbers of men and women in the study arrived at the hospital by ambulance, a woman’s pain was less likely to be immediately identified as a potential heart attack. On average, women waited about 11 minutes longer to be evaluated by a clinician. Women were also significantly less likely to be given an electrocardiogram (EKG) – a standard initial test used to diagnose heart attacks – to receive cardiac monitoring, or to be seen by a consulting specialist such as a cardiologist.

While the study did not examine the reasons behind the differences in emergency treatment found in the study, the study’s lead author, Darcy Banco, M.D., said that healthcare providers’ “preconceived notions” regarding men’s higher relative risk of heart attacks most likely play a role. She suggested that clinicians become more aware that younger women represent a growing portion of heart attack patients, and that their heart attacks often present with different symptoms than men’s.

“We are learning that heart attacks take many forms,” Banco said. “We need to continue to raise awareness and make sure all patients are diagnosed and treated properly, even if they’re not the ‘classic’ demographic for a heart attack.” 

This study is the first to examine emergency room management of chest pain specifically among younger adults. It was presented at the American College of Cardiology Annual Scientific Session in May.

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