Abstract 17831: Sex Differences in Symptoms Presentation and Perception of Symptoms among Young Patients with MI: The VIRGO Study
Background: Studies of older patients with myocardial infarction (MI) reveal women are less likely to experience chest pain and commonly attribute symptoms to non-cardiac conditions as compared with men. Information on younger patients is limited.
Methods: The VIRGO Study enrolled 2990 MI patients, aged 18-55 years, from 104 US hospitals from 8/21/08 to 1/5/12 using a 2:1 female/male enrollment design. Information on MI symptoms, perceived cause of symptoms, and interactions with the healthcare system for symptoms was collected from patient interviews during the hospitalization. Sex differences were compared using Pearson χ2 tests.
Results: 90% of men and 87% of women presented with chest pain, pressure, tightness, or discomfort; women presented with more additional symptoms (Figure). Among those presenting without chest pain, there were no differences in symptoms by sex, with only 9% presenting with no classical symptoms. Almost 60% of participants attributed symptoms to non-cardiac conditions; women commonly cited indigestion or stress/anxiety, whereas men reported indigestion or muscle pain. More women reported waiting >1 day to seek care than men (55% vs 49%, p<0.05). Persistent symptoms was the most common care seeking trigger for men and women, but women were less likely to report concern about heart disease as a trigger for seeking care (41% vs 49%, p<0.001). Almost 1 in 3 women and 1 in 5 men visited their doctor for symptoms before their hospitalization; 45% of women and 62% of men (p<0.001) reported being told their symptoms might be related to a heart problem. About half of women said their doctor ever talked with them about heart disease versus 60% of men (p<0.001). When they first went for help, 87% of men and 75% of women (p<0.001) reported their care provider thought they were having a problem with their heart.
Conclusion: Young men and women predominantly present with chest pain, but young women more commonly misattribute their symptoms to a non-cardiac cause.
- © 2012 by American Heart Association, Inc.