Women with coronary heart disease were more likely than men to present with nausea and/or vomiting (OR 2.43; 95% CI 1.23-4.79; p=0.011), although chest pain was the most common symptom in both.
Observational (n=217)
No
Are there gender differences in symptom presentation among patients presenting to the emergency department who are subsequently diagnosed with coronary heart disease?
While women with acute coronary heart disease are more likely to experience associated symptoms like nausea and indigestion, chest pain remains the predominant and equally common presenting symptom for both men and women.
Odds Ratio: 2.43 (95% CI 1.23–4.79)
p-value: p=0.011
This study explores gender differences in symptom presentation associated with coronary heart disease (CHD). In this prospective study, nurse data collectors directly observed 550 patients as they presented to the Emergency Department (ED) of Yale-New Haven Hospital. The final sample included 217 patients (41% women) diagnosed with CHD (acute coronary ischemia or myocardial infarction). Chest pain was the most frequently reported symptom in women (70%) and men (71%). Unadjusted analyses revealed that women were more likely than men to present with midback pain (odds ratio OR 9.61, 95% confidence interval CI 2.10 to 44.11, p = 0.001), nausea and/or vomiting (OR 2.29, 95% CI 1.19 to 4.42, p = 0.012), dyspnea (OR 1.82, 95% CI 1.05 to 3.16, p = 0.032), palpitations (OR 3.42, 95% CI 1.02 to 11.47, p = 0.036), and indigestion (OR 2.13, 95% CI 1.03 to 4.44, p = 0.040). After adjustment for age and diabetes, women were more likely to present with nausea and/or vomiting (OR 2.43, 95% CI 1.23 to 4.79, p = 0.011) and indigestion (OR 2.13, 95% CI 1.10 to 4.53, p = 0.048). Women (30%) and men (29%) were equally likely to present without chest pain, and dyspnea was the most common non-chest pain symptom. In the subgroup of patients without chest pain, unadjusted analyses revealed that women were more likely to report nausea and/or vomiting compared with men (OR 4.40, 95% CI 1.30 to 14.84, p = 0.013). Although we found some significant gender differences in non-chest pain symptoms, we conclude that there were more similarities than differences in symptoms in women and men presenting to the ED with symptoms suggestive of CHD who were later diagnosed with CHD.
Milner et al. (1999) conducted an observational in Coronary heart disease (n=217). Female gender vs. Male gender was evaluated on Nausea and/or vomiting (adjusted for age and diabetes) (OR 2.43, 95% CI 1.23-4.79, p=0.011). Women with coronary heart disease were more likely than men to present with nausea and/or vomiting (OR 2.43; 95% CI 1.23-4.79; p=0.011), although chest pain was the most common symptom in both.