Women in the ED

Different symptoms mean different treatment

A myocardial infarction (heart attack) is one common but often devastating reason for women to visit the emergency department (ED). While a number of symptoms are known to occur before or during a heart attack, chest pain that often radiates to the arm has long been considered the "classic heart attack symptom." However, women are more likely than men to experience other common symptoms such as shortness of breath, weakness, fatigue, nausea, and back, neck, or jaw pain in addition to or instead of chest discomfort.^26-28

According to Dr. Judith S. Hochman, Director of Cardiovascular Clinical Research, New York University School of Medicine, symptoms can differ according to a woman's age as well. "[Women] may not feel typical pressure of the center of the chest. They may have pressure or tightness or discomfort in the upper belly or in the neck or jaw, or in the left arm or right arm or both. Sometimes they may only experience shortness of breath and they may feel no sense of chest pain or discomfort. And older women in particular may just experience fatigue."

Because women can experience atypical symptoms, they often come into the ED later than men with the same severity of attack.

Says Dr. C Noel Bairey Merz, Director of the Preventive & Rehabilitative Cardiac Center, Cedars-Sinai Medical Center, "Women will come into the emergency room on average 2-3 hours later [when experiencing a heart attack], and for a variety of reasons are often less promptly attended to. They are also less likely to get the artery opening treatments when we know a heart attack is in process." (View her video at right.)

Misdiagnoses and mistreatment of women in the ED is a problem that needs to be addressed through increased education for diagnosing healthcare providers as well as their female patients. To view and read a case study of one woman's experience with misdiagnoses in the ED, meet Julia Carson in HHC Stories.