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April 24, 2026CureusOpen Access

Gender-Based Disparities in the Evaluation and Management of Acute Coronary Syndromes

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Key result

Women with acute myocardial infarction experience significant diagnostic delays, receiving an electrocardiogram in a mean of 12.7 minutes compared to 6.7 minutes for men, contributing to worse outcomes.

Population

Women presenting with acute coronary syndromes or acute chest pain in the emergency department setting

Design

Editorial

Authors

JRJami RanceNova Southeastern UniversityMKMarc M KesselmanNova Southeastern University

Discussion

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Implication

Women presenting with acute coronary syndromes face significant diagnostic delays and worse clinical outcomes due to atypical symptom presentation and systemic biases, highlighting the need for standardized, gender-aware triage protocols.

Key Points

  • To examine gender-based disparities in the clinical evaluation, triage, and management of acute coronary syndromes and identify contributing clinical and systemic factors.
  • Editorial synthesis evaluating literature on sex differences in acute coronary syndrome presentation, emergency department triage, door-to-electrocardiogram timing, and clinical outcomes.
  • Review of published cohort and qualitative data comparing clinical trajectories, complication rates, revascularization procedures, and mortality between men and women.
  • Women experience marked diagnostic delays, with mean door-to-electrocardiogram times of 12.7 min compared with 6.7 min in men, exceeding the clinical benchmark of less than 10 min.
  • From 2000-2009, women experienced a significantly higher 30-day mortality rate of 16.4% compared to 11.7% in men, with young women (ages 21-55 years) experiencing a 30-day mortality nearly 45% higher than men of the same age.
  • Women with acute myocardial infarction are less likely to receive revascularization via coronary angiography within 30 days and have higher rates of complications and longer hospital stays.

Structured PICO

P
Population
Women presenting with acute coronary syndromes or acute chest pain in the emergency department setting

Women presenting with acute coronary syndromes face significant diagnostic delays and worse clinical outcomes due to atypical symptom presentation and systemic biases, highlighting the need for standardized, gender-aware triage protocols.

Limitations

  • Women, particularly young women, have historically been underrepresented in cardiovascular clinical trials, limiting the development of diagnostic criteria and risk stratification tools.

Cite This Study

Rance et al. (2026) conducted an editorial in Acute Coronary Syndromes. Women with acute myocardial infarction experience significant diagnostic delays, receiving an electrocardiogram in a mean of 12.7 minutes compared to 6.7 minutes for men, contributing to worse outcomes.

synapsesocial.com/papers/69eb084f553a5433e34b3655https://doi.org/10.7759/cureus.107483
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Also Consider

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  1. 1Raising awareness about cardiovascular disease in women2023 · 8 citations
  2. 2Gender Bias in Cardiovascular Testing Persists after Adjustment for Presenting Characteristics and Cardiac Risk2007 · 102 citations
  3. 3Sex-based Disparities in Myocardial Infarction2024
  4. 4Time is up for treatment inequity in women with acute coronary syndromes2018 · 5 citations
  5. 5Sex- and Gender-Related Disparities in the Management of Acute Coronary Syndrome: A Mixed-Methods Study2025 · 1 citations