Heart attacks in women more likely to be missed

Health news

Women have a 50 per cent higher chance than men of receiving the wrong initial diagnosis following a heart attack, according to a new study by the University of Leeds.

Using the UK national heart attack register MINAP2, researchers found that overall, almost one-third (29.9 per cent) of patients had an initial diagnosis which differed from their final diagnosis. 

The two main types of heart attack are STEMI and NSTEMI. 

STEMI occurs when there’s a total blockage of the main artery that pumps oxygenated blood around the body. 

NSTEMI, which is more common, is a partial blockage of one or more arteries. Both result in serious damage to the heart muscle.

This research found that women who had a final diagnosis of STEMI had a 59 per cent greater chance of a misdiagnosis compared with men. 

Women who had a final diagnosis of NSTEMI had a 41 per cent greater chance of a misdiagnosis when compared with men.

Receiving a quick diagnosis and getting the correct treatment after a heart attack is paramount to ensure the best possible recovery, the researchers said.

The initial diagnosis is vital as it shapes treatment in the short-term, and sometimes in the long-term. Women who were misdiagnosed had about a 70 per cent increased risk of death after 30 days compared with those who had received a consistent diagnosis. The same was the case for men. 

The study, published in the European Heart Journal Acute Cardiovascular Care, looked at nearly 600,000 heart attack patients over the course of nine years. 

Between April 2004 and March 2013, the researchers studied 243 NHS hospitals in England and Wales that provided care for patients between the ages of 18 – 100 at the time of hospitalisation. The number of patients who were initially misdiagnosed was 198,534. 

The British Heart Foundation, which part-funded the research, is urging both the public and health care professionals to be more aware of the signs and symptoms of a heart attack, to avoid mistakes being made in diagnosis. 

The BHF also say more research is needed to further improve tests for diagnosing heart attacks in both men and women.

Dr Chris Gale, Associate Professor of Cardiovascular Health Sciences at the University of Leeds who worked on the study, said:

“This research clearly shows that women are at a higher risk of being misdiagnosed following a heart attack than men. 

“When people with heart attack receive the wrong initial diagnosis, there are potentially important clinical repercussions, including an increased risk of death. 

“We need to work harder to shift the perception that heart attacks only affect a certain type of person. 

“Typically, when we think of a person with a heart attack, we envisage a middle aged man who is overweight, has diabetes and smokes. 

“This is not always the case; heart attacks affect the wider spectrum of the population – including women.”

Dr Mike Knapton, Associate Medical Director at the British Heart Foundation, said:

“Thanks to this study we now have a better understanding of the experiences of both men and women when they are diagnosed as having suffered a heart attack.  

“The difference is alarmingly high, but recent BHF research in Edinburgh has shown why this might be. 

“The research shows that when different limits are applied to the troponin test, a routine test for a heart attack, more women receive a correct diagnosis of heart attack. Thanks to this research there is now a better test for female heart attack diagnoses. 

“However, 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.” 

Someone suffers a heart attack approximately every three minutes in the UK. 

A heart attack is caused when a blood clot forms in a narrowed coronary artery, cutting off the blood supply to the heart muscle.

28,000 women die from heart attacks each year in the UK, an average of 77 women per day. 

To request an interview with Dr Chris Gale or for more information please call Sophie Freeman in the University of Leeds press office on 0113 343 8059 or email s.j.freeman@leeds.ac.uk