Sex bias skews heart attack tests
WOMEN ARE twice as likely to be given a wrong diagnosis after a heart attack than a man, according to a study by Yorkshire scientists which is published today.
Almost one-third – 29.9 per cent – of patients had an initial diagnosis which differed from their final diagnosis. The study by Leeds University is based on the UK national heart attack register and looked at nearly 600,000 heart attack patients over the course of nine years.
Researcher Dr Chris Gale noted that an initial misdiagnosis could have “potentially important clinical repercussions, including an increased risk of death”.
The study, which was carried out between April 2004 and March 2013, involves 243 NHS hospitals in England and Wales which cared for patients who were aged between 18 to 100 years old when they were admitted. Researchers found that 198,534 patients were initially misdiagnosed.
Heart attacks can be broken down into two main types – called Stemi and Nstemi – according to the British Heart Foundation (BHF), which part-funded the study.
A Stemi attack occurs when there is a total blockage of the main artery that pumps oxygenated blood around the body. The more common Nstemi type of heart attack involves a partial blockage of one or more arteries. Both result in serious damage to the heart muscle.
Women who had a final diagnosis of Stemi had a 59 per cent greater chance of a misdiagnosis compared with men, according to the study in the European Heart Journal Acute Cardiovascular Care. Women who had a final diagnosis of Nstemi had a 41 per cent greater chance of a misdiagnosis when compared with men.
The BHF’s associate medical director Dr Mike Knapton described the differences in diagnosis as “alarmingly high” but said that better tests were being developed for female heart attack diagnoses.
He said: “This new study highlights the current scale of the issue and confirms more research is urgently needed into tests that will enable earlier and more accurate diagnosis of a heart attack, particularly in women.”
Up to 28,000 women die from heart attacks each year in the UK, according to BHF estimates.
There are also about 275,000 female heart attack survivors in the UK, many of whom will be living with heart failure as a result of this illness. The longer a heart attack is left undiagnosed and untreated, the more the heart muscle can be irreversibly damaged.
A total of 68,000 women also go to hospital following a heart attack each year in the UK – an average of 186 women per day, or eight per hour.
The symptoms of a heart attack vary from person to person and women’s symptoms can differ from “classic” chest pain. Pain radiating to the arms, neck, jaw, stomach and back can all be symptoms of a heart attack and for some people the pain is severe but for others just uncomfortable.
A general feeling of being unwell or lethargic can also be an indicator of a heart attack when accompanied by chest pain or discomfort.
Other signs include a feeling of indigestion or reflux type pain which is often ignored in the hope that it will pass and feeling sick, sweaty, breathless or lightheaded with associated chest pain or discomfort. The BHF recommends that all women over the age of 40 visit their local GP or nurse for a health check and say this check may help to highlight anything that could put a person at increased risk of having a heart attack.
This new study highlights the current scale of the issue Mike Knapton, associate director of the British Heart Foundation