Is Severity of Chest Pain a Cue for Women and Men to Recognize Acute Myocardial Infarction Symptoms as Cardiac in Origin?

Recognizing symptoms as cardiac in origin is associated with the prompt seeking of medical care in patients with acute myocardial infarction (AMI). Therefore, the authors compared the symptom attribution of men and women experiencing AMI and examined factors associated with cardiac attribution by sex. In a cross-sectional study, a total of 1059 AMI patients were consecutively recruited across 5 countries. A structured interview was performed during hospitalization. Approximately 40% of both men and women interpreted their symptoms as cardiac in origin. In men, a history of coronary heart disease (CHD) and chest pain severity were significantly associated with symptom interpretation as cardiac in origin (odds ratio [OR], 4.0; 95% confidence interval [CI], 2.9-5.6; OR, 2.0; 95% CI, 1.4-2.7, respectively). In women, a history of CHD was also significantly associated with symptom interpretation as cardiac in origin (OR, 4.95; 95% CI, 2.39-10.25), but not severity of chest pain. As opposed to men, severe chest pain may not be a cue for women to interpret their symptom as cardiac in origin. Education and counseling must take sex differences into account to be effective.