1. Joy, Subhashni D. Singh MA

Article Content

According to this study:


* Health care workers need to educate women on their risk of myocardial infarction and its broad range of symptoms.



The chance of dying from a heart attack can be reduced if reperfusion therapy is begun within one hour of symptom onset. However, many patients-women in particular-delay seeking care for an extended time after symptoms begin.


A number of variables have been found to increase delay time before presentation to the ED, including diagnosed hypertension, diabetes, or heart disease; symptom onset during daylight hours; dyspnea rather than chest pain; and female sex, black race, older age, and lower socioeconomic status.


Being able to attribute symptoms to a heart attack is known to affect time to presentation, and chest pain is the primary symptom that prompts people to seek medical attention quickly. Public education campaigns that highlight chest pain as the primary symptom of myocardial infarction are effective, but the author states that educational interventions should also focus on recognizing atypical symptoms. One study found that women in particular may experience intermittent or atypical symptoms that may lengthen the delay, including heartburn, dull pain, and fatigue.


Another factor that may lengthen the delay for women is their social role in the family and household. One study found that women did not want to trouble others, so they delayed going to the hospital after symptoms arose. Also, women may be less likely than men to believe they are at risk for a myocardial infarction.


Educating women on the wide range of heart attack symptoms and making sure they are aware of their risk of myocardial infarction can decrease delays. The author also suggests that women be taught coping skills that focus on problem solving to help them avoid using coping mechanisms, such as denial, suppression, and greater concern for others than oneself, that can delay care and threaten health.


Waller CG. Critical Pathways in Cardiology 2006;5(4):228-34.