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Posted July 23, 2018 14:45:22

There's a difference in how men and women are being treated for heart attacks.

Women who experience a serious type of heart attack, known as STEMI, are less likely to receive appropriate treatment, a new study has found.

And they are twice as likely to die in the six months after their heart attack.

'A bit tight in my chest'

Helene Peck was just 41 when she suffered a heart attack.

It was a health scare she never anticipated.

"I wasn't overweight, I didn't have blood pressure, I didn't have high cholesterol," Ms Peck told AM.

"I actually didn't really fit the bill of what anyone would have probably looked at and thought that person looks like a candidate.

Symptoms of a heart attack include:

  • Tightness or heaviness in your chest that becomes severe
  • Pain in the shoulders and/or arms
  • Jaw and neck pain
  • Sudden difficulty breathing
  • Nausea
  • If you or someone you know is experiencing heart attack symptoms, call triple-0 immediately
Source: Heart Research Australia

"I was thin, I was running five businesses — I guess I was just a bit superhuman, I thought, but I wasn't taking great care of myself."

When the first symptoms started to show, she had no idea what was happening, but she knew she needed to get to a hospital quickly.

"I wasn't really sure what this actually was, but I knew it wasn't quite right.

"And then I just had quite a severe pain come through my back into the front of my chest.

"And then I thought, 'Oh, I'm a bit tight in my chest here, this doesn't feel great.'"

Women less likely to get treatment than men

Revascularisation therapies: male/female

Revascularisation therapy Men Women
Coronary angiography 95.7 pc 89.1 pc
Total revascularisation 91.7 pc 79.0 pc
Timely revascularisation 42.3 pc 33.9 pc
Percutaneous coronary intervention (PCI) 77.8 pc 65.0 pc
Thrombolysis 32.3 pc 31.5 pc
Coronary artery bypass graft (CABG) 7.5 pc 3.5 pc
Source: Med J Aust doi: 10.5694/mja17.01109

Ms Peck's quick thinking, and the actions of medical staff meant she got the care she needed.

But a study published today in the Medical Journal of Australia has found other women are having a different experience.

"We set out to work out in modern-day Australia whether women compared to men have the same outcomes with STEMI, which is a serious type of heart attack," Clara Chow, a senior author of the study, a professor of medicine at the University of Sydney and a cardiologist at Westmead Hospital, said.

The study used data from the CONCORDANCE acute coronary syndrome registry, which covers 41 hospitals across Australia.

It found that women were less likely to get a coronary angiogram (a test to find blockages in the coronary artery), less likely to get preventative treatments after their heart attack, and less likely to be referred for cardiac rehabilitation.

"So they were less likely to get treatment compared to men," Professor Chow said.

Adverse events, in hospital and at six months

Inpatient event Men Women
Major adverse cardiac events, in hospital 12.1 pc 16.9 pc
Major adverse cardiac events, at six months 3.8 pc 11.6 pc
Mortality, in hospital 5.3 pc 9.0 pc
Mortality, at six months 2.2 pc 6.3 pc
Source: Med J Aust doi: 10.5694/mja17.01109

Unconscious bias

The research did not determine why sometimes there is a difference in the way men and women are treated for heart attacks.

But Professor Chow thinks unconscious bias can play a part.

"Certainly I do think that men recognise and health services recognise that men have heart attacks, but there is definitely the perception that women don't have heart attacks," she said.

"Yet cardiovascular disease is the leading cause of death in both men and women."

And that unconscious bias can also extend to medical professionals, according to Garry Jennings, a cardiologist and medical adviser to the Heart Foundation.

"If a woman comes along with symptoms that could be a heart attack, they tend to think that it's less likely to be the diagnosis than other things," Professor Jennings said.

"We need to counter that. It's not true.

"Just as many women have heart disease as do men, and it's very important that we make sure they get the best treatment."

Professor Chow said there needed to be awareness this was happening, and the gaps must be addressed immediately.

"There are no differences in our treatment protocols by gender … gender shouldn't come into it at all," she said.

Topics: heart-disease, womens-health, healthcare-facilities, australia

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