Symptoms Across the Continuum of Acute Coronary Syndromes: Differences Between Women and Men

BACKGROUND: The urgency and level of care provided for acute coronary syndromes partially depends on the symptoms manifested. OBJECTIVES: To detect differences between women and men in the type, severity, location, and quality of symptoms across the 3 clinical diagnostic categories of acute coronary syndromes (unstable angina, myocardial infarction without ST-segment elevation, and myocardial infarction with ST-segment elevation) while controlling for age, diabetes, functional status, anxiety, and depression. METHODS: A convenience sample of 112 women and 144 men admitted through the emergency department and hospitalized for acute coronary syndromes participated. Recruitment took place at 2 urban teaching hospitals in the Midwest. Data were collected during structured interviews in each patient's hospital room. Forty-eight symptom descriptors were assessed. Demographic characteristics, health history, functional status, anxiety, and depression levels also were measured. RESULTS: Regardless of clinical diagnostic category, women reported significantly more indigestion (beta = 0.25; confidence interval CI = 0.01-0.49), palpitations (beta = 0.31; CI = 0.06-0.56), nausea (beta = 0.37; CI = 0.10-0.65), numbness in the hands (beta = 0.29; CI = 0.02-0.57), and unusual fatigue (beta = 0.60; CI = 0.27-0.93) than men reported. Differences between men and women in dizziness, weakness, and new-onset cough did differ by diagnosis. Reports of chest pain did not differ between men and women. CONCLUSIONS: Women with acute coronary syndromes reported a higher intensity of 5 symptoms (but not chest pain) than men reported. Whether differences between the sexes in less typical symptoms are clinically significant remains unclear.